title: Safety and feasibility of collateral blood flow augmentation after intravenous thrombolysis.
abstract: OBJECTIVE
  Collateral flow augmentation using partial aortic occlusion may improve cerebral perfusion in acute stroke. We assessed the safety and feasibility of partial aortic occlusion immediately after intravenous tissue plasminogen activator.
  
  
  METHODS
  We conducted an open-label pilot study of partial aortic occlusion after thrombolysis. The primary end point was all serious adverse events within 30 days of treatment.
  
  
  RESULTS
  None of the 22 patients enrolled developed symptomatic parenchymal hemorrhages. Asymptomatic hemorrhagic transformation occurred in 9 patients. Procedure-related adverse events were limited to groin complications (n=13). Seventy-seven percent of patients experienced neurological improvement (≥4-point improvement of the National Institutes of Health Stroke Scale score).
  
  
  CONCLUSIONS
  Partial aortic occlusion as an adjunct to thrombolysis in the treatment of acute stroke appears safe. Studies aimed at determining the efficacy of this therapeutic approach are warranted.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique Identifier: NCT01006993.
authors.affiliation: Department of Radiology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Emery
authors.forename: Peter D
authors.initials: PD
authors.lastname: Schellinger
authors.forename: Daniel
authors.initials: D
authors.lastname: Selchen
authors.forename: Andre G
authors.initials: AG
authors.lastname: Douen
authors.forename: Richard
authors.initials: R
authors.lastname: Chan
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Shuaib
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Butcher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000503:physiopathology; D021721:Balloon Occlusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology*; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000503:physiopathology / Q000628:therapy*; D007262:Infusions, Intravenous / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator