title: Intravenous thrombolysis in acute ischemic stroke due to occlusion of internal carotid artery - a Serbian Experience with Thrombolysis in Ischemic Stroke (SETIS).
abstract: OBJECTIVE
  The benefit of intravenous thrombolysis in patients with internal carotid artery (ICA) occlusion is still unclear. The aim of this study was to assess the influence on outcome of intravenous thrombolysis in patients with ICA occlusion comparing to those without it.
  
  
  METHODS
  Data were from the national register of all acute ischemic stroke patients treated with intravenous thrombolysis in Serbia. Patients with nonlacunar anterior circulation infarction were included and were divided into two groups, those with and those without ICA occlusion. We compared the differences in demographic characteristics, risk factors, baseline NIHSS score, early neurological improvement, 3-month functional outcome, complications and death between these two groups.
  
  
  RESULTS
  Among 521 included patients there were 13.4% with ICA occlusion. Group with ICA occlusion had more males (82.9% vs. 60.5%; p=0.0008), and more severe stroke (baseline NIHSS score 15.3 vs. 13.6; p=0.004). Excellent functional outcome (mRS 0-1) at 3 months was recorded in 32.9% patients with ICA occlusion and in 50.6% patients without (p=0.009), while favorable functional outcome (mRS 0-2) was recorded in 50.0% of patients with ICA occlusion vs. 60.1% without (p=0.14). Death occurred in 12.9% patients with ICA occlusion and in 17.3% patients without it (p=0.40). There was no significant difference in rate of symptomatic ICH between the two groups (1.4% vs. 4.2%; p=0.5). Multivariate logistic regression analysis showed that ICA occlusion was associated with the absence of early neurological improvement (p=0.03; OR 1.78, 95% CI 1.05-3.04). However, the presence of ICA occlusion was not significantly associated with an unfavorable outcome at 3-month (p=0.44; OR 1.24, 95% CI 0.72-2.16) or with death (p=0.18; OR 0.57, 95% CI 0.25-1.29).
  
  
  CONCLUSIONS
  The patients with ICA occlusion treated with intravenous thrombolysis have a worse outcome than patients without it.
authors.affiliation: Medical Faculty, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia. Electronic address: drzzivanovic79@gmail.com.
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Zivanovic
authors.affiliation: Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia.
authors.forename: Slobodan
authors.initials: S
authors.lastname: Gvozdenovic
authors.affiliation: Medical Faculty, University of Belgrade, Belgrade, Serbia; Department of Neurology, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Dejana R
authors.initials: DR
authors.lastname: Jovanovic
authors.affiliation: Medical Faculty, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Lucic-Prokin
authors.affiliation: Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Sekaric
authors.affiliation: Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia.
authors.forename: Sonja
authors.initials: S
authors.lastname: Lukic
authors.affiliation: Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia.
authors.forename: Timea
authors.initials: T
authors.lastname: Kokai-Zekic
authors.affiliation: Medical Faculty, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia.
authors.forename: Marija
authors.initials: M
authors.lastname: Zarkov
authors.affiliation: Medical Faculty, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia.
authors.forename: Milan
authors.initials: M
authors.lastname: Cvijanovic
authors.affiliation: Medical Faculty, University of Belgrade, Belgrade, Serbia; Department of Neurology, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Beslac-Bumbasirevic
authors.affiliation: Medical Faculty, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia.
authors.forename: Petar
authors.initials: P
authors.lastname: Slankamenac
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D002340:Carotid Artery Diseases / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D002343:Carotid Artery, Internal / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D055771:Serbia; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Internal carotid artery; Intravenous thrombolysis; Occlusion; Outcome; SETIS