title: Simultaneous administration of recombinant tissue plasminogen activator and edaravone in acute cerebral ischemic stroke patients.
abstract: Among the 1052 patients admitted to our hospital because of cerebral infarction between January 1, 2007, and December 31, 2010, we report the treatment outcomes of 48 patients (4.6% of all patients) who received recombinant tissue plasminogen activator (rt-PA) therapy (simultaneously combined with edaravone) within 3 hours after the onset of infarction. Twenty (41.7%) patients started receiving edaravone before rt-PA administration, and 28 patients (58.3%) started receiving rt-PA and edaravone simultaneously. The patients had an average age of 73.5 years (range, 55-93 years; male:female, 32:16). Medical histories included hypertension, diabetes mellitus, dyslipidemia, arterial fibrillation, and a smoking history in 23 (47.8%), 7 (14.6%), 8 (16.7%), 29 (60.4%), and 8 (16.7%) of patients, respectively. Regarding the treatment outcome of the therapy, the National Institutes of Health Stroke Scale score, which was 15 points before rt-PA administration, showed a statistically significant improvement to 8 points after rt-PA administration (P < .001). The modified Rankin Scale scores at 90 days after treatment were as follows: 0 in 12 patients (25.0%), 1 in 11 patients (22.9%), 2 in 7 patients (14.6%), 3 in 5 patients (10.4%), 4 in 6 patients (12.5%), 5 in 5 patients (10.4%), and 6 in 2 patients (4.2%). The occluded blood vessel reopened completely in 30 patients (62.5%) and partially in 5 patients (10.4%). Asymptomatic hemorrhage over the entire brain developed in 2 patients (4.2%). Thus, rt-PA therapy in combination with edaravone improved the recanalization rate, reduced the incidence of intracranial hemorrhage, and improved functional prognosis.
authors.affiliation: Department of Neurological Surgery, Takayama Red Cross Hospital, Takayama, Japan. Electronic address: takenakaka@mbm.nifty.com.
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Takenaka
authors.affiliation: Department of Neurological Surgery, Takayama Red Cross Hospital, Takayama, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Neurological Surgery, Takayama Red Cross Hospital, Takayama, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Yamauti
authors.affiliation: Department of Neurological Surgery, Takayama Red Cross Hospital, Takayama, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000983:Antipyrine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002545:Brain Ischemia / Q000188:drug therapy*; D003131:Combined Modality Therapy; D000077553:Edaravone; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000188:drug therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D016166:Free Radical Scavengers; D010959:Tissue Plasminogen Activator; D000077553:Edaravone; D000983:Antipyrine
keywords: Edaravone; cerebral infarction; recombinant tissue plasminogen activator; rehabilitation