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(Stroke. 2005;36:1083.)
© 2005 American Heart Association, Inc.

Research Report

Intra-Arterial Thrombolytic Therapy in Peri-Coronary Angiography Ischemic Stroke

Osama O. Zaidat, MD; Andy P. Slivka, MD; Yousef Mohammad, MD; Carmelo Graffagnino, MD; Tony P. Smith, MD; David S. Enterline, MD; Greg A. Christoforidis, MD; Michael J. Alexander, MD; Dennis M.D. Landis, MD Jose I. Suarez, MD

From the Department of Neurology (O.O.Z., J.I.S., D.M.D.L.), Case Western Reserve University, Cleveland, Ohio; the Departments of Radiology (O.O.Z., M.J.A, T.P.S, D.S.E) and Neurosurgery (M.J.A.), Duke University and Medical Center, Durham, NC; and the Departments of Neurology (M.Y, A.P.S) and Radiology (G.A.C), Ohio State University, Columbus.

Correspondence to Osama O. Zaidat, MD, Duke University and Medical Center, Box 3808, Durham, NC 27710. E-mail ozaidat{at}hotmail.com

Background— Intra-arterial thrombolysis (IAT) for peri-coronary angiography (CA) stroke may be safe and efficacious. However, IAT may increase the risk of intracranial hemorrhage (ICH).

Methods— A retrospective study was performed involving 3 university hospitals. All peri-CA IAT-treated cases were identified. Patient demographics, stroke severity, angiographic findings, thrombolytic use, modified Rankin Scale (mRS), ICH, and mortality were determined.

Results— A total of 21 patients with post–left CA stroke were treated with IAT (mean age 71.8±12.3 years). Arterial occlusion was found in 14 (66.7%) and 7 (33.3%) of the anterior and posterior circulation, respectively. Mean time-to-therapy was 36±12 minutes from the time the neurological deficit was noted. mRS 2 occurred in 10 of 21 (48%) patients. Patients with younger age and shorter time-to-IAT had more complete arterial recanalization and clinical recovery. Symptomatic ICH occurred in 3 (14%) cases, and 4 (19%) patients died.

Conclusions— Peri-CA IAT appears to be feasible and safe without increased risk of symptomatic ICH and death when compared with the previously reported IAT literature.

Key Words: cardiac catheterization • cerebrovascular disorders • stroke • tissue plasminogen activator • thrombolysis

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