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(Stroke. 2007;38:192.)
© 2007 American Heart Association, Inc.

Research Reports

Early Recanalization After Intravenous Administration of Recombinant Tissue Plasminogen Activator as Assessed by Pre- and Post-Thrombolytic Angiography in Acute Ischemic Stroke Patients

Kyung-Yul Lee, MD, PhD; Sang Won Han, MD; Seo Hyun Kim, MD; Hyo Seok Nam, MD; Sung Whan Ahn, MD; Dong Joon Kim, MD; Sang Hyun Seo, MD; Dong Ik Kim, MD Ji Hoe Heo, MD, PhD

From the Department of Neurology, National Core Research Center for Nanomedical Technology (K.-Y.L., S.W.H., S.H.K., H.S.N., S.W.A., J.H.H.) and Diagnostic Radiology (D.J.K., D.I.K., S.H.S.), Yonsei University College of Medicine, Seoul, Korea.

Correspondence to Ji Hoe Heo, MD, PhD, Department of Neurology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-ku, 120-752, Seoul, Korea. E-mail jhheo{at}yumc.yonsei.ac.kr

Background and Purpose— Recanalization rates after the intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment have been poorly studied in acute stroke.

Methods— CT angiography was performed before IV rt-PA in all patients and digital subtraction angiography was undertaken for intra-arterial thrombolysis in cases of no improvement after rt-PA infusion.

Results— Forty-five patients were treated with IV rt-PA. Initial CT angiography showed relevant arterial occlusions in 35 patients. Recanalization after rt-PA therapy was demonstrated by digital subtraction angiography in 7 of the 31 patients with the occlusion on initial CT angiography: 2/16 in the internal carotid or proximal middle cerebral artery, 3/11 in the distal middle cerebral artery and 2/4 in the basilar artery occlusion.

Conclusions— The early recanalization rate after IV rt-PA use was very low in cases with large proximal arterial occlusions. CT angiography before IV rt-PA may be useful for the prediction of its efficacy.

Key Words: CT angiography • thrombolysis • tissue plasminogen activator

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