title: Recanalization of extracranial internal carotid artery occlusion after i.v. thrombolysis for acute ischemic stroke.
abstract: BACKGROUND
  Although extracranial internal carotid artery (e-ICA) occlusion is a common pathology in patients undergoing intravenous thrombolysis for treatment of acute ischemic stroke, no data on e-ICA recanalization rate or potential effects on outcome are yet available.
  
  
  RESULTS
  This study included 52 consecutive patients with e-ICA occlusion and ischemic stroke undergoing standard intravenous thrombolysis. The rate of e-ICA recanalization was 30.8% [95%CI, 18.2-43.3], documented at 3.5 [2.0-11.8] (median [IQR]) days after stroke, as compared to 8.6% [95%CI, 3.5-13.7] in a series of 116 consecutive patients with symptomatic e-ICA occlusion not undergoing thrombolysis (P<0.001 for difference). Functional outcome three months after stroke did not significantly differ for those with or without e-ICA recanalization following intravenous thrombolysis (modified Rankin scale ≤2: 31.3% vs. 22.2%, odds ratio 1.6 [95%CI, 0.4-5.9], P = 0.506). In patients with e-ICA occlusion of atherothrombotic origin, recanalization resulted in most instances in residual high-grade stenosis (13 of 14).
  
  
  CONCLUSIONS
  Recanalization of e-ICA occlusion after stroke thrombolysis occurred in about one third of patients. Although e-ICA recanalization had no significant effect on patient outcome, control sonography in the early days after thrombolysis is recommended for the detection of potential residual e-ICA stenosis.
authors: Department of Neurology, Innsbruck Medical University, Innsbruck, Tyrol, Austria.
authors: Raimund
authors: R
authors: Pechlaner
authors: Michael
authors: M
authors: Knoflach
authors: Benjamin
authors: B
authors: Matosevic
authors: Michael
authors: M
authors: Ruecker
authors: Christoph
authors: C
authors: Schmidauer
authors: Stefan
authors: S
authors: Kiechl
authors: Johann
authors: J
authors: Willeit
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography
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