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Late recanalisation beyond 24 hours is associated with worse outcome: an observational study.
- Source :
-
European radiology [Eur Radiol] 2017 Jan; Vol. 27 (1), pp. 24-31. Date of Electronic Publication: 2016 Apr 23. - Publication Year :
- 2017
-
Abstract
- Objectives: We evaluated the rate of late recanalisation beyond 24 h after intravenous thrombolysis (IVT) and its relationship with haemorrhagic transformation and outcome.<br />Methods: We reviewed prospectively collected clinical and imaging data from acute ischaemic stroke patients with distal internal carotid artery or proximal middle cerebral artery occlusion who underwent angiography on admission, 24 h and 1 week after IVT. Patients were trichotomised according to vascular status: timely recanalisation (<24 h), late recanalisation (24 h-7 days), and no recanalisation.<br />Results: Non-invasive angiography revealed timely recanalisation in 52 (50.0 %) patients, late recanalisation in 25 (24.0 %) patients, and no recanalisation in 27 (26.0 %) patients. Pre-existing atrial fibrillation was associated with the occurrence of late recanalisation (odds ratio 6.674; 95 % CI: 1.197 to 37.209; p = 0.030). In patients without timely recanalisation, shift analysis indicated that late recanalisation led to a worse modified Rankin Scale score (odds ratio 6.787; 95 % CI: 2.094 to 21.978; p = 0.001).<br />Conclusions: About half of all patients without recanalisation by 24 h after IVT may develop late recanalisation within 1 week, along with higher mRS scores by 3 months. Pre-existing atrial fibrillation is an independent predictor for late recanalisation.<br />Key Points: • About half of patients may develop late recanalisation within 1 week. • Pre-existing atrial fibrillation was associated with the occurrence of late recanalisation. • Late recanalisation led to a higher mRS score than no recanalisation.
- Subjects :
- Administration, Intravenous
Adult
Aged
Aged, 80 and over
Brain Ischemia diagnosis
Brain Ischemia etiology
Cerebral Angiography
Female
Humans
Infarction, Middle Cerebral Artery complications
Infarction, Middle Cerebral Artery diagnosis
Male
Middle Aged
Treatment Outcome
Brain Ischemia therapy
Fibrinolytic Agents administration & dosage
Infarction, Middle Cerebral Artery therapy
Thrombolytic Therapy methods
Tissue Plasminogen Activator administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 27
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 27108298
- Full Text :
- https://doi.org/10.1007/s00330-016-4366-7