Published Online
on November 16, 2006

A more recent version of this article appeared on January 1, 2007

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Submitted on July 11, 2006
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; 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; and 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.

^* 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.

Key words: CT angiography • thrombolysis • tissue plasminogen activator

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