Current Status of Recanalization Therapy in Acute Ischemic Stroke with Symptomatic Intracranial Arterial Occlusion in Korea

Title
Current Status of Recanalization Therapy in Acute Ischemic Stroke with Symptomatic Intracranial Arterial Occlusion in Korea
Author(s)
이준Min Uk Jang[Min Uk Jang]Jeong-Ho Hong[Jeong-Ho Hong]Jihoon Kang[Jihoon Kang]Beom Joon Kim[Beom Joon Kim]Moon-Ku Han[Moon-Ku Han]Byung-Chun Lee[Byung-Chun Lee]Kyung-Ho Yu[Kyung-Ho Yu]Mi Sun Oh[Mi Sun Oh]Hee-Joon Bae[Hee-Joon Bae]
Keywords
TISSUE-PLASMINOGEN ACTIVATOR; ENDOVASCULAR TREATMENT; MECHANICAL THROMBECTOMY; THROMBOLYTIC THERAPY; TRIAL; ASSOCIATION; IMPROVEMENT; OUTCOMES; DESIGN; IMPACT
Issue Date
201405
Publisher
ELSEVIER SCIENCE BV
Citation
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, v.23, no.5, pp.E339 - E346
Abstract
Background: Recent methodological advances in recanalization therapy may alter recanalization strategies and clinical outcomes in patients with symptomatic occlusion of intracranial cerebral arteries. However, few studies have analyzed these changes at a national level, with none conducted in Korea. Methods: On the basis of a prospective multicenter stroke registry database in Korea, 642 consecutive patients hospitalized within 12 hours of the onset with symptomatic occlusion of intracranial major cerebral arteries between March 2010 and November 2011 were identified. Recanalization therapy was used in 48% (n = 307) of patients; intravenous thrombolysis only (IVT) in 46%, intra-arterial thrombolysis only (IAT) in 16%, and combined thrombolysis (CMT) in 38%. Of the 166 patients treated by IAT or CMT, the Penumbra system or the Solitaire was used in 58% of patients. Results: Early neurologic improvement (ENI), 3-month modified Rankin scale (mRS) score of 2 or less, and symptomatic hemorrhagic transformation (SHT) were observed in 43%, 39%, and 9% of the patients in the IVT group; 52%, 27%, and 12% of the patients in the IAT group; and 54%, 39%, and 12% of the patients in the CMT group, respectively. Compared with no treatment, adjusted odd ratios (95% confidence intervals) of recanalization therapy were 1.59 (1.04-2.42) for ENI, 1.37 (.81-2.30) for 3-month mRS score of 2 or less, and 2.58 (1.12-5.91) for SHT. Conclusions: The variety and active use of endovascular approaches were quite noticeable. As a whole, recanalization therapy tended to contribute to favorable outcomes despite a significant increase of symptomatic hemorrhage.
URI
http://hdl.handle.net/YU.REPOSITORY/32210http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2013.12.027
ISSN
1052-3057
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의과대학 > 신경과학교실 > Articles
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