Abstract | BACKGROUND AND PURPOSE: METHODS: We compared clinical outcomes in consecutive patients presenting with tandem internal carotid and middle cerebral artery occlusion with internal carotid artery dissection within 3 hours of symptom onset who were eligible for intravenous thrombolysis, treated by either endovascular stent-assisted thrombolysis or intravenous recombinant tissue-type plasminogen activator (rtPA) when an endovascular therapist was unavailable. National Institutes of Health Stroke Scale scores were obtained at baseline and after 24 hours. The modified Rankin Scale score was used to assess outcomes at 3 months. Arterial recanalization was assessed by magnetic resonance imaging. RESULTS: Of 10 patients screened, 6 were treated with endovascular therapy and 4 with intravenous rtPA. Before treatment, mean National Institutes of Health Stroke Scale scores were high and comparable in the 2 groups (17 and 16, respectively). In the endovascular group, all patients achieved middle cerebral artery recanalization with subsequent dramatic improvement versus only 1 patient with middle cerebral artery recanalization in the intravenous rtPA group. At 3 months, 4 patients in the endovascular group had a favorable outcome (modified Rankin Scale score=0). In the intravenous rtPA group, 3 patients had a poor outcome (modified Rankin Scale score> or =3). CONCLUSIONS:
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Authors | Philippa C Lavallée, Mickaël Mazighi, Jean-Pierre Saint-Maurice, Elena Meseguer, Halim Abboud, Isabelle F Klein, Emmanuel Houdart, Pierre Amarenco |
Journal | Stroke
(Stroke)
Vol. 38
Issue 8
Pg. 2270-4
(Aug 2007)
ISSN: 1524-4628 [Electronic] United States |
PMID | 17600235
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Tissue Plasminogen Activator
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Topics |
- Adult
- Angioplasty
(standards, statistics & numerical data)
- Carotid Artery Thrombosis
(therapy)
- Carotid Artery, Internal
(pathology, physiopathology)
- Carotid Artery, Internal, Dissection
(therapy)
- Female
- Humans
- Infarction, Middle Cerebral Artery
(therapy)
- Injections, Intravenous
- Magnetic Resonance Angiography
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Middle Cerebral Artery
(pathology, physiopathology)
- Stents
- Thrombolytic Therapy
(instrumentation, methods)
- Tissue Plasminogen Activator
(administration & dosage)
- Treatment Outcome
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