on November 16, 2006
Published online before print November 16, 2006, doi: 10.1161/01.STR.0000251788.03914.00
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Submitted on July 11, 2006
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. * To whom correspondence should be addressed. 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.
Revised on August 3, 2006
Accepted on September 6, 2006
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;
Key words: CT angiography • thrombolysis • tissue plasminogen activator
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