title: Intra-arterial therapy as a rescue strategy after clinically failed intravenous thrombolysis may increase the likelihood of a good outcome in patients with severe ischaemic stroke. A retrospective two centre study.
abstract: The purpose of this study was to evaluate the efficacy and safety of intra-arterial therapy as a rescue strategy after clinically failed intravenous thrombolysis (IVT) in acute ischaemic stroke patients. We conducted a retrospective analysis of consecutive acute ischaemic stroke patients treated with rescue therapy. The results from this study group were compared with those obtained from a control group consisting of 260 consecutive patients treated with IVT alone. The study group consisted of 52 patients with a mean age of 63 years and a median NIHSS score at admission of 17. Recanalization was achieved in 92% with a symptomatic haemorrhage rate of 9.6%. Rescue patients admitted with a severe stroke (NIHSS score >12) had a significantly better outcome at 90 days compared to patients with the same score but treated with IVT alone. No difference was seen for patients with a lower score at admission. This study indicates that rescue therapy may increase the proportion of patients with independent outcome if presenting with a severe stroke (NIHSS score >12) without increasing the rate of symptomatic haemorrhage.
authors: Stroke Unit, Department of Neuroscience, "S. Agostino Estense" Hospital; Modena, Italy - tommy.andersson@karolinska.se.
authors: Federico
authors: F
authors: Menetti
authors: Stroke Unit, Department of Neuroscience, "S. Agostino Estense" Hospital; Modena, Italy.
authors: Luca
authors: L
authors: Verganti
authors: Stroke Unit, Department of Neuroscience, "S. Agostino Estense" Hospital; Modena, Italy.
authors: Andrea
authors: A
authors: Zini
authors: Stroke Unit, Department of Neuroscience, "S. Agostino Estense" Hospital; Modena, Italy.
authors: Stefano
authors: S
authors: Vallone
authors: Stroke Unit, Department of Neuroscience, "S. Agostino Estense" Hospital; Modena, Italy.
authors: Paolo
authors: P
authors: Carpeggiani
authors: Karolinska University Hospital; Stockholm, Sweden.
authors: Tommy
authors: T
authors: Andersson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D002536:Cerebral Arteries / Q000601:surgery*; D002548:Cerebral Revascularization / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D013548:Sweden; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: acute ischaemic stroke; intra-arterial treatment; intravenous thrombolysis; rescue therapy