title: Angioplasty as an adjuvant therapy for the treatment of acute ischemic stroke.
abstract: BACKGROUND
  Different endovascular techniques can be employed to achieve vessel recanalization in acute stroke. We assessed whether an endovascular strategy that included angioplasty was safe and effectively recanalized acutely occluded intracranial vessels.
  
  
  METHODS
  We retrospectively reviewed 70 patients that received intra-arterial therapy for acute stroke. Patients were divided into two groups depending on whether they had received angioplasty as part of their endovascular treatment.
  
  
  RESULTS
  Angioplasty was used in the treatment of 35/70 patients (50%). Median baseline NIHSS was 15. The site of occlusion was at the M1 in 11 patients, M1/M2 in 3, ICA/M1 in 13 and vertebrobasilar in 8 patients. Intravenous thrombolysis was administered to 16/35 patients (46%). Angioplasty was used alone in 4 patients, in combination with intra-arterial thrombolysis in 27 and with a mechanical retrieval device or stent in 13 patients. Recanalization (TICI 2-3) was achieved in 23/35 patients (66%). Median time from symptom onset to recanalization was six hours. In patients where angioplasty was employed, symptomatic intracranial hemorrhage occurred in 2/35 (6%), which was similar to patients that were not treated with angioplasty. A favorable functional outcome (mRS=2) was achieved in 20% (7/35) at 24 hour and 34% (12/35) at one month. All patients that had a favorable outcome had recanalized.
  
  
  CONCLUSIONS
  In this small cohort, an endovascular treatment strategy that employed angioplasty was safe and effectively recanalized acutely occluded intracranial vessels. Angioplasty should be considered as a potential treatment option in interventional acute stroke trials.
authors.affiliation: Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alhazzaa
authors.forename: Amanda
authors.initials: A
authors.lastname: Murphy
authors.forename: Cheemun
authors.initials: C
authors.lastname: Lum
authors.forename: Marlise P
authors.initials: MP
authors.lastname: Dos Santos
authors.forename: Howard
authors.initials: H
authors.lastname: Lesiuk
authors.forename: Miguel
authors.initials: M
authors.lastname: Bussière
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents