TITLE

Clinical and radiological predictors of recanalisation and outcome of 40 patients with acute basilar artery occlusion treated with intra-arterial thrombolysis

AUTHOR(S)
Arnold, M.; Nedeltchev, K.; Schroth, G.; Baumgartner, R. W.; Remonda, L.; Loher, T. J.; Stepper, F.; Sturzenegger, M.; Schuknecht, B.; Mattle, H. P.
PUB. DATE
June 2004
SOURCE
Journal of Neurology, Neurosurgery & Psychiatry;Jun2004, Vol. 75 Issue 6, p857
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Objective: To define predictors of recanalisation and clinical outcome of patients with acute basilar artery occlusions treated with local intra-arterial thrombolysis (IAT).Methods: Vascular risk factors, severity of the neurological deficit graded by the National Institutes of Health stroke scale (NIHSS), and radiological findings were recorded at presentation. Outcome was measured using the modified Rankin scale (mRS) three months later and categorised as favourable (mRS 0-2), poor (mRS 3-5), or death (mRS 6).Results: 40 patients were studied. Median NIHSS on admission was 18. Mean time from symptom onset to treatment was 5.5 hours (range 2.3 to 11). Outcome was favourable in 14 patients (35%) and poor in nine (23%); 17 (42%) died. There were two symptomatic cerebral haemorrhages (5%). Recanalisation of the basilar artery was achieved in 32 patients (80%); it was complete (TIMI grade 3) in 20% and partial (TIMI grade 2) in 60%. In multivariate logistic regression analysis, low NIHSS score on admission (p = 0.002) and vessel recanalisation (p = 0.005) were independent predictors of favourable outcome. Recanalisation occurred more often with treatment within six hours of symptom onset (p = 0.003) and when admission computed tomography showed a hyperdense basilar artery sign (p = 0.007). In a univariate model, quadriplegia (p = 0.002) and coma (p = 0.004) were associated with a poor outcome or death.Conclusions: Low baseline NIHSS on admission and recanalisation of basilar artery occlusions predict a favourable outcome after intra-arterial thrombolysis. Early initiation of IAT and the presence of a hyperdense basilar artery sign on CT were associated with a higher likelihood of recanalisation.
ACCESSION #
13542657

 

Related Articles

  • Influence of direct admission to Comprehensive Stroke Centers on the outcome of acute stroke patients treated with intravenous thrombolysis. de la Ossa, Natalia Pérez; Millán, Mónica; Arenillas, Juan F.; Sánchez-Ojanguren, Josep; Palomeras, Ernest; Dorado, Laura; Guerrero, Cristina; Dávalos, Antoni // Journal of Neurology;Aug2009, Vol. 256 Issue 8, p1270 

    Acute stroke patients can be transferred directly to a Comprehensive Stroke Center (CSC), where acute stroke expertise is provided 24 h a day, seven days a week, and thrombolytic treatment is administered; or they may initially receive attention at an unspecialized community hospital with...

  • Not All "Successful" Angiographic Reperfusion Patients Are an Equal Validation of a Modified TICI Scoring System. ALMEKHLAFI, MOHAMMED A.; MISHRA, SACHIN; DESAI, JAMSHEED A.; NAMBIAR, VIVEK; VOLNY, ONDREJ; GOEL, ANKUR; EESA, MUNEER; DEMCHUK, ANDREW M.; MENON, BIJOY K.; GOYAL, MAYANK // Interventional Neuroradiology;Jan/Feb2014, Vol. 20 Issue 1, p21 

    Rapid reperfusion of the entire territory distal to vascular occlusions is the aim of stroke interventions. Recent studies defined successful reperfusion as establishing some perfusion with distal branch filling of <50% of territory visualized (Thrombolysis In Cerebral Infarction "TICI" 2a) or...

  • Management of acute basilar artery occlusion: Should any treatment strategy prevail? Dornak, Tomas; Herzig, Roman; Sanak, Daniel; Skoloudik, David // Biomedical Papers of the Medical Faculty of Palacky University i;Dec2014, Vol. 158 Issue 4, p528 

    Background. Acute basilar artery occlusion (BAO) is relatively infrequent form of acute ischemic stroke associated with severe and persisting neurological deficit and high mortality rate (to 86%). Early recanalization is essential for good clinical outcome but the most effective treatment...

  • Effect of X-Ray Attenuation of Arterial Obstructions on Intravenous Thrombolysis and Outcome after Ischemic Stroke. Mair, Grant; von Kummer, Rüdiger; Lindley, Richard I.; Sandercock, Peter A. G.; Wardlaw, Joanna M.; null, null // PLoS ONE;12/23/2015, Vol. 10 Issue 12, p1 

    Objective: To assess whether the x-ray attenuation of intra-arterial obstruction measured on non-contrast CT in ischemic stroke can predict response to thrombolysis and subsequent functional outcome. Methods: The Third International Stroke Trial (IST-3) was a multicenter randomized-controlled...

  • Ten Years' Experience in Early Cerebral Aneurysm Clip Occlusion. Bălaşa, A.; Chinezu, R.; Ács, J.; Györki, G.; Gherman, B.; Luşa, A.; Gherasim, D. N. // Acta Medica Marisiensis;2012, Vol. 58 Issue 3, p143 

    Background: The study follows the complete series of patients surgically treated in the past 10 years at Targu Mures Neurosurgery Department and the effects of the surgical experience over the clinical outcome. Material and method: This is a retrospective study including 382 patients operated in...

  • Stroke Emergency Medical Care: Initial Assessment, Risk Factors, Triage and Hospitalization Outcome. Suljic, Enra; Mehicevic, Admir; Gavranovic, Aida // Materia Socio Medica;2013, Vol. 25 Issue 2, p83 

    Goals: The goals of this research are: a) to determine the number, gender and age representation of patients with a working diagnosis of acute stroke referred by the Institute for Emergency Medical Care (IEMC) in the Clinical Center of Sarajevo University (CCSU); b) determine the incidence of...

  • IV Thrombolysis 3-4.5 Hours After Stroke:Time for a Change? Segal, Alan Z. // Neurology Alert;Nov2008, Vol. 27 Issue 3, p17 

    INTRAVENOUS RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR (TPA) for acute ischemic stroke benefits a tiny minority of patients due to its strict limitation to a 3-hour period following symptom onset. Until now, attempts to extend this narrow time window have failed. Clinical trials enrolling patients...

  • Highlights of the Issue 9, 2014.  // Neurological Sciences;Sep2014, Vol. 35 Issue 9, p1319 

    No abstract available.

  • Intravenous thrombolysis for minor stroke and rapidly improving symptoms: a quantitative overview. Huang, Qiang; Ma, Qingfeng; Jia, Jianping; Wu, Jian // Neurological Sciences;Sep2014, Vol. 35 Issue 9, p1321 

    Minor stroke and rapidly improving symptoms (MRIS) are usually excluded from intravenous thrombolysis (IVT) considering a possible benign prognosis and potential bleeding risk. However, its risk-benefit profile from IVT has not been fully illustrated. We searched PubMed for articles published up...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics