Recanalization Therapy for Internal Carotid Artery Occlusion Presenting as Acute Ischemic Stroke

Title
Recanalization Therapy for Internal Carotid Artery Occlusion Presenting as Acute Ischemic Stroke
Author(s)
이준Jeong-Ho Hong[Jeong-Ho Hong]Jihoon Kang[Jihoon Kang]Min Uk Jang[Min Uk Jang]Beom Joon Kim[Beom Joon Kim]Moon-Ku Han[Moon-Ku Han]Kyung Bok Han[Kyung Bok Han]Byung-Chul Lee[Byung-Chul Lee]Kyung-Ho Yu[Kyung-Ho Yu]Hee-Joon Bae[Hee-Joon Bae]
Keywords
TISSUE-PLASMINOGEN-ACTIVATOR; INTRAARTERIAL THERAPY; INTERVENTIONAL MANAGEMENT; ENDOVASCULAR TREATMENT; CLINICAL-TRIAL; 0.6 MG/KG; THROMBOLYSIS; THROMBECTOMY; EXPERIENCE; ALTEPLASE
Issue Date
201409
Publisher
ELSEVIER SCIENCE BV
Citation
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, v.23, no.8, pp.2183 - 2189
Abstract
Background: We aimed to describe the current status and clinical outcomes of recanalization therapy for internal carotid artery occlusion (ICAO) presenting as acute ischemic stroke. Methods: Using a nationwide stroke registry database in Korea, we identified consecutive ischemic stroke patients with ICAO hospitalized within 12 hours of onset between March 2010 and November 2011. Results: ICAO accounted for 10.6% (322 of 3028) of acute ischemic strokes within 12 hours of onset. Among the 322 ICAO patients, 53% underwent recanalization therapy, 41% intravenous thrombolysis (IVT) alone, and 59% endovascular treatment (EVT). Twenty-two percent of those with mild deficits (National Institutes of Health Stroke Scale <4) and 50% of those 80 years of age or more received recanalization therapy. Compared with no treatment, recanalization therapy was not significantly associated with a favorable outcome (3-month modified Rankin scale, 0-2) (adjusted odds ratio [OR], 1.77; 95% confidence interval [CI], .80-3.91; P = .16). However, compared with IVT, EVT significantly improved the odds of favorable outcome (OR, 2.86; 95% CI, 1.19-6.88; P = .02) without significant increase of symptomatic intracranial hemorrhage (OR, 2.18; 95% CI, .42-11.43; P = .36) and 3-month mortality (OR, .53; 95% CI, .23-1.18; P = .12). Successful recanalization rate (Thrombolysis in Cerebral Infarction >= 2a) by EVT was 76%. Conclusions: In Korea, one tenth of acute ischemic stroke was caused by ICAO, and about 50% were treated by recanalization therapy. EVT was widely used as a recanalization modality (about 60% of cases) despite lack of evidence. However, its effectiveness and safety were acceptable.
URI
http://hdl.handle.net/YU.REPOSITORY/30803http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.025
ISSN
1052-3057
Appears in Collections:
의과대학 > 신경과학교실 > Articles
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