title: Early recanalization rate of major occluded brain arteries after intravenous tissue plasminogen activator therapy using serial magnetic resonance angiography studies.
abstract: OBJECTIVE
  The present study investigated early recanalization rate of major occluded arteries after tissue plasminogen activator (t-PA) infusion using serial magnetic resonance angiography (MRA) studies.
  
  
  METHODS
  Consecutive stroke patients treated with t-PA within 3 h of onset were prospectively studied. Four serial MRA studies were conducted: before, immediately, 24 h and 5-7 days after t-PA infusion.
  
  
  RESULTS
  Initial MRA demonstrated occluded brain arteries in 64 patients: M1 occlusion, 30 patients; M2, 12, and internal carotid artery (ICA), 22. Combining M1 and M2 occlusion, the recanalization rates (complete and partial) were 52.3% (19.0 and 33.3%) within 1 h, 80.9% (47.6 and 33.3%) at 24 h and 87.8% (73.2 and 14.6%) 7 days after t-PA infusion. However, the recanalization rate of ICA occlusion was 31.8% (4.5 and 27.3%) within 1 h, 51.1% (14.3 and 47.6%) at 24 h and 66.7% (38.9 and 27.8%) 7 days after t-PA infusion. Complete recanalization rate at 24 h and 7 days was lower in ICA occlusion than M1 and M2 occlusion (p = 0.014 and p = 0.016).
  
  
  CONCLUSIONS
  Within 1 h after t-PA infusion, approximately half the patients with major arteries occlusion had early recanalization. ICA occlusion is resistant to intravenous t-PA therapy compared with middle cerebral artery occlusion.
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan. kimurak@med.kawasaki-m.ac.jp
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Iguchi
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shibazaki
authors.forename: Junya
authors.initials: J
authors.lastname: Aoki
authors.forename: Junichi
authors.initials: J
authors.lastname: Uemura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000188:drug therapy* / Q000473:pathology; D002545:Brain Ischemia / Q000188:drug therapy* / Q000473:pathology; D002536:Cerebral Arteries / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D018579:Patient Selection; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D010959:Tissue Plasminogen Activator