Early recanalization after intravenous administration of recombinant tissue plasminogen activator as assessed by pre- and post-thrombolytic angiography in acute ischemic stroke patients.
OBJECTIVE
Recanalization rates after the intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment have been poorly studied in acute stroke.


METHODS
CT angiography was performed before IV rt-PA in all patients and digital subtraction angiography was undertaken for intra-arterial thrombolysis in cases of no improvement after rt-PA infusion.


RESULTS
Forty-five patients were treated with IV rt-PA. Initial CT angiography showed relevant arterial occlusions in 35 patients. Recanalization after rt-PA therapy was demonstrated by digital subtraction angiography in 7 of the 31 patients with the occlusion on initial CT angiography: 2/16 in the internal carotid or proximal middle cerebral artery, 3/11 in the distal middle cerebral artery and 2/4 in the basilar artery occlusion.


CONCLUSIONS
The early recanalization rate after IV rt-PA use was very low in cases with large proximal arterial occlusions. CT angiography before IV rt-PA may be useful for the prediction of its efficacy.
Lee
Kyung-Yul
KY
Department of Neurology, National Core Research Center for Nanomedical Technology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-ku, 120-752, Seoul, Korea.
Han
Sang Won
SW
Kim
Seo Hyun
SH
Nam
Hyo Seok
HS
Ahn
Sung Whan
SW
Kim
Dong Joon
DJ
Seo
Sang Hyun
SH
Kim
Dong Ik
DI
Heo
Ji Hoe
JH
D015901:Angiography, Digital Subtraction / Q000379:methods / Q000592:standards; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D002533:Cerebral Angiography / Q000379:methods* / Q000592:standards; D002536:Cerebral Arteries / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000503:physiopathology; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D011993:Recombinant Fusion Proteins; D010959:Tissue Plasminogen Activator