title: Recanalization of occluded large arteries with broadened therapeutic window for acute cerebral infarction.
abstract: OBJECTIVE
  To investigate the safety and efficacy of recanalization with a broadened therapeutic window for acute occlusion of large cerebral arteries.
  
  
  METHODS
  We assessed 38 patients who underwent the hyper-selective intra-arterial administration of low-dose urokinase, along with mechanical thrombus disruption or mechanical thrombus disruption recanalization (34 stents in 33 patients) of occluded vessels, 20 with onset time-to-treatment (OTT) >6 h (observation group; mean OTT, 20.10±15.67 h) and 18 with OTT ≤6 h (control group). NIHSS scores, mRS scores (≤2) at 3 months, recanalization rates, severe cerebral infarctions on CT, and symptomatic hemorrhagic conversions after surgery were compared.
  
  
  RESULTS
  Postoperative recanalization rates were 100% in both groups, and other results were equivalent.
  
  
  CONCLUSIONS
  Recanalization at longer OTT was safe and effective with acute occlusions of large cerebral arteries. Time to recanalization could be safely prolonged for up to 20 h in these patients.
authors.affiliation: Department of Neurology, the Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, NO. 157 West 5 Road, Xi'an 710004, Shaanxi Province, China. zhgl_2006@126.com
authors.forename: Guilian
authors.initials: G
authors.lastname: Zhang
authors.forename: Ru
authors.initials: R
authors.lastname: Zhang
authors.forename: Haiqin
authors.initials: H
authors.lastname: Wu
authors.forename: Huqing
authors.initials: H
authors.lastname: Wang
authors.forename: Wanggang
authors.initials: W
authors.lastname: Zhang
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Hong
authors.initials: H
authors.lastname: Sun
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.forename: Ning
authors.initials: N
authors.lastname: Bu
authors.forename: Yun
authors.initials: Y
authors.lastname: Du
authors.forename: Li
authors.initials: L
authors.lastname: Yao
authors.forename: Jingjie
authors.initials: J
authors.lastname: Liu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001488:Basilar Artery / Q000473:pathology; D020520:Brain Infarction / Q000601:surgery*; D003328:Coronary Thrombosis / Q000150:complications; D018450:Disease Progression; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology; D020765:Intracranial Arterial Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D019990:Perioperative Care; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome