Abstract WP1: Recanalization Therapy For Acute Symptomatic Occlusion Of The Intracranial Cerebral Arteries In Korea
Background: Despite its clinical importance in the Koreans, the status of recanalization therapy for acute occlusion of the intracranial cerebral arteries has not been reported yet.
Methods: Using a nationwide stroke registry, a consecutive series of 642 patients with symptomatic occlusion of intracranial arteries were identified among 3028 who were hospitalized within 12 h of stroke onset at 10 participating centers between 2010 and 2011. Demographics, clinical characteristics, clinical outcomes, and type of recanalization therapy were described.
Results: The mean age was 68.6 years (57.2% males, median baseline NIHSS 12). MCA was most commonly affected vessel (65.1%), followed by intracranial ICA (15.3%), PCA (14.2%), basilar artery (11.1%), and ACA (5.1%). Recanalization therapy was applied in 307 patients (47.8%); intravenous thrombolysis only (IVT) in 45.9%, and endovascular treatment (ET) in 54.1%. Intravenous thrombolysis treatment preceded ET in 69.9%. Doses of tPA were 0.6mg/kg in 22.3% and 0.9mg/kg in 77.7%. Recanalization therapy according to occluded vessels and onset-to-arrival time is described in the Table. Recanalization by IAT as seen on angiography was complete (thrombolysis in cerebral infarction [TICI] grade 3) in 29.5% and partial (TICI grade 2A or 2B) in 50.6%. Solitaire were applied to 48.8% of patients with ET and recanalization rate was 86.4%, and Penumbra were applied to 15.1% and recanalization rate (TICI grade 2A~3) was 76.0%. Favorable outcome (modified Rankin Scale, 0-2) was achieved in 39.4% of those with IVT and in 35.4% of those with ET, and symptomatic hemorrhagic transformation occurred in 8.5% and 12.0%, respectively.
Conclusion: This study shows that a considerable proportion of patients with symptomatic occlusion of intracranial cerebral arteries are treated by endovascular approach. Efficacy and safety of endovascular approach in this setting should be tested by randomized clinical trials.
- © 2012 by American Heart Association, Inc.