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Combined intravenous and intraarterial revascularization therapy using MRI perfusion/diffusion mismatch selection for acute ischemic stroke at 3-6 h after symptom onset
DC Field | Value | Language |
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dc.contributor.author | Han, Moon-Ku | - |
dc.contributor.author | Kim, Sung Hyun | - |
dc.contributor.author | Ko, Sang-Bae | - |
dc.contributor.author | Paik, Nam-Jong | - |
dc.contributor.author | Kwon, O-Ki | - |
dc.contributor.author | Lee, Yong-Seok | - |
dc.contributor.author | Oh, Chang-Wan | - |
dc.contributor.author | Kim, Jae Hyoung | - |
dc.contributor.author | Park, Seong-Ho | - |
dc.contributor.author | Bae, Hee-Joon | - |
dc.date.accessioned | 2010-07-01T07:05:21Z | - |
dc.date.available | 2010-07-01T07:05:21Z | - |
dc.date.issued | 2008-03-15 | - |
dc.identifier.citation | Neurocrit Care. 2008;8(3):353-359 | en |
dc.identifier.issn | 1541-6933 (Print) | - |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18340411 | - |
dc.identifier.uri | http://www.springerlink.com/content/bk96g30611v85w60/fulltext.pdf | - |
dc.identifier.uri | https://hdl.handle.net/10371/68160 | - |
dc.description.abstract | BACKGROUND AND PURPOSE: Intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) has demonstrated favorable clinical outcomes in a 3-6 h window in patients selected with perfusion/diffusion mismatch. However, the advantages of combined IV and intraarterial (IA) thrombolysis after 3 h of stroke onset are unexplored. METHODS: Acute ischemic stroke patients with persistent occlusion of intracranial large arteries were screened prospectively for thrombolysis by evaluating perfusion/diffusion mismatch on MRI. The IV rt-PA was initiated within 3-6 h, and additional urokinase (UK) was then administered via the IA route after angiography. RESULTS: Four patients had middle cerebral artery occlusion and one patient had an internal carotid artery occlusion. The median time from the symptom onset to the initiation of IV therapy and to the initiation of IA treatment was 215 +/- 30 min and 292 +/- 41 min, respectively. The median National Institutes of Health Stroke Scale (NIHSS) scores were as follows: initial, 13; immediately after IA treatment, 8; at 24 h, 5; and at 7 days, 3. The Thrombolysis in Myocardial Infarction (TIMI) score after the completion of thrombolysis was 2-3. Four patients without intracerebral hemorrhage recovered completely or exhibited mild disability and one patient with hemorrhage also demonstrated a favorable outcome. CONCLUSION: This preliminary result suggests that if a significant perfusion/diffusion mismatch on MRI is identified, a sequential combination thrombolysis of IV rt-PA and IA UK is potentially beneficial in moderate to severe acute ischemic stroke patients who are treated within 3-6 h after symptom onset. | en |
dc.description.sponsorship | This study was supported partly by a grant of
the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (A060171) and a grant of the SNUBH Research Fund (09-2004-007). | en |
dc.language.iso | en | en |
dc.publisher | Humana Press (Springer Imprint) | en |
dc.subject | Acute Disease | en |
dc.subject | Adult | en |
dc.subject | Aged | en |
dc.subject | Brain Ischemia/*drug therapy/*pathology/radiography | en |
dc.subject | Cerebral Angiography | en |
dc.subject | Cerebral Revascularization | en |
dc.subject | Drug Therapy, Combination | en |
dc.subject | Feasibility Studies | en |
dc.subject | Female | en |
dc.subject | Fibrinolytic Agents/administration & dosage | en |
dc.subject | Humans | en |
dc.subject | Injections, Intra-Arterial | en |
dc.subject | Injections, Intravenous | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Prospective Studies | en |
dc.subject | Stroke/*drug therapy/*pathology/radiography | en |
dc.subject | Thrombolytic Therapy/*methods | en |
dc.subject | Tissue Plasminogen Activator/administration & dosage | en |
dc.subject | Treatment Outcome | en |
dc.subject | Urokinase-Type Plasminogen Activator/administration & dosage | en |
dc.subject | Diffusion Magnetic Resonance Imaging | - |
dc.title | Combined intravenous and intraarterial revascularization therapy using MRI perfusion/diffusion mismatch selection for acute ischemic stroke at 3-6 h after symptom onset | en |
dc.type | Article | en |
dc.contributor.AlternativeAuthor | 한문구 | - |
dc.contributor.AlternativeAuthor | 김성현 | - |
dc.contributor.AlternativeAuthor | 고상배 | - |
dc.contributor.AlternativeAuthor | 백남종 | - |
dc.contributor.AlternativeAuthor | 권오기 | - |
dc.contributor.AlternativeAuthor | 이용석 | - |
dc.contributor.AlternativeAuthor | 오창완 | - |
dc.contributor.AlternativeAuthor | 김재형 | - |
dc.contributor.AlternativeAuthor | 박성호 | - |
dc.contributor.AlternativeAuthor | 배희준 | - |
dc.identifier.doi | 10.1007/s12028-007-9046-7 | - |
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