title: Intra-arterial vasodilator use during endovascular therapy for acute ischemic stroke might improve reperfusion rate.
abstract: Treatment of acute ischemic stroke (AIS) is an evolving field. New treatment options are still needed in order to achieve greater success rates for arterial recanalization. Intra-arterial therapy (lAT) is an option for AIS patients who are not good candidates for intravenous (i.v.) recombinant tissue plasminogen activator (rt-PA) or where it has failed. While good data establishing the role of IAT in AIS management are lacking, the potential clinical efficacy of IAT is based on the premise that recanalization and reperfusion may result in better clinical outcome. Although lAT recanalization and reperfusion rates of large vessel occlusion are much higher than they are for i.v. rt-PA, IAT's radiological efficacy is still far from perfect. Vasodilator use during IAT for AIS may increase the recanalization and reperfusion rates of such therapy. In this report, we describe the radiographic and clinical outcomes in a cohort of AIS patients who received intra-arterial (i.a.) vasodilators during IAT and summarize the role of i.a. vasodilators in the process of recanalization and reperfusion.
authors.affiliation: Department of Neurology, SUNY Upstate Medical University, Syracuse, New York, USA. elzammaz@upstate.edu
authors.forename: Ziad M K
authors.initials: ZM
authors.lastname: El-Zammar
authors.forename: Julius Gene S
authors.initials: JG
authors.lastname: Latorre
authors.forename: Dongliang
authors.initials: D
authors.lastname: Wang
authors.forename: Shyama
authors.initials: S
authors.lastname: Satyan
authors.forename: Elwaleed
authors.initials: E
authors.lastname: Elnour
authors.forename: Adham
authors.initials: A
authors.lastname: Kamel
authors.forename: Ashok
authors.initials: A
authors.lastname: Devasenapathy
authors.forename: Yahia M
authors.initials: YM
authors.lastname: Lodi
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D002560:Cerebrovascular Circulation; D003131:Combined Modality Therapy; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use*; D011859:Radiography; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D015424:Reperfusion; D012189:Retrospective Studies; D017131:Thrombectomy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014700:Verapamil / Q000008:administration & dosage / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D002121:Calcium Channel Blockers; D011994:Recombinant Proteins; D014665:Vasodilator Agents; D014700:Verapamil; D010959:Tissue Plasminogen Activator; D005996:Nitroglycerin