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Thrombolysis in ischemic stroke without arterial occlusion at presentation.
- Source :
-
Stroke [Stroke] 2014 Sep; Vol. 45 (9), pp. 2722-7. Date of Electronic Publication: 2014 Jul 29. - Publication Year :
- 2014
-
Abstract
- Background and Purpose: None of the randomized trials of intravenous tissue-type plasminogen activator reported vascular imaging acquired before thrombolysis. Efficacy of tissue-type plasminogen activator in stroke without arterial occlusion on vascular imaging remains unknown and speculative.<br />Methods: We performed a retrospective, multicenter study to collect data of patients who presented to participating centers during a 5-year period with ischemic stroke diagnosed by clinical examination and MRI and with imaging evidence of no vascular occlusion. These patients were divided into 2 groups: those who received thrombolytic therapy and those who did not. Primary outcome measure of the study was excellent clinical outcome defined as modified Rankin Scale of 0 to 1 at 90 days from stroke onset. Secondary outcome measures were good clinical outcome (modified Rankin Scale, 0-2) and perfect outcome (modified Rankin Scale, 0). Safety outcome measures were incidence of symptomatic intracerebral hemorrhage and poor outcome (modified Rankin Scale, 4-6).<br />Results: A total of 256 patients met study criteria, 103 with thrombolysis and 153 without. Logistic regression analysis showed that patients who received thrombolysis had more frequent excellent outcomes with odds ratio of 3.79 (P<0.01). Symptomatic intracerebral hemorrhage was more frequent in thrombolysis group (4.9 versus 0.7%; P=0.04). Thrombolysis led to more frequent excellent outcome in nonlacunar group with odds ratio 4.90 (P<0.01) and more frequent perfect outcome in lacunar group with odds ratio 8.25 (P<0.01).<br />Conclusions: This study provides crucial data that patients with ischemic stroke who do not have visible arterial occlusion at presentation may benefit from thrombolysis.<br /> (© 2014 American Heart Association, Inc.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Infusions, Intravenous
International Cooperation
Magnetic Resonance Imaging
Male
Middle Aged
Odds Ratio
Regression Analysis
Retrospective Studies
Risk Factors
Treatment Outcome
Young Adult
Arterial Occlusive Diseases therapy
Brain Ischemia therapy
Stroke therapy
Thrombolytic Therapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4628
- Volume :
- 45
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Stroke
- Publication Type :
- Academic Journal
- Accession number :
- 25074517
- Full Text :
- https://doi.org/10.1161/STROKEAHA.114.005757