التفاصيل البيبلوغرافية
| العنوان: |
Conservative Medical Treatment and Intravenous Thrombolysis in Acute Stroke from Carotid T Occlusion. |
| المؤلفون: |
Wunderlich, Michael T., Stolz, Erwin, Seidel, Günter, Postert, Thomas, Gahn, Georg, Sliwka, Ulrich, Goertler, Michael |
| المصدر: |
Cerebrovascular Diseases; 2005, Vol. 20 Issue 5, p355-361, 7p, 1 Color Photograph, 2 Charts, 1 Graph |
| مصطلحات موضوعية: |
THROMBOLYTIC therapy, ARTERIAL occlusions, CAROTID artery diseases, CEREBROVASCULAR disease, DUPLEX ultrasonography |
| مستخلص: |
Background: We aimed to analyse the course of early recanalization and corresponding functional outcome in patients with an acute occlusion of the carotid T who were treated conservatively or underwent intravenous thrombolysis. Methods: Forty-two patients with an acute occlusion of the carotid T within 6 h were recruited from consecutive admissions to a neurological department participating in the Duplex Sonography in Acute Stroke study. All patients underwent a standardized admission and follow-up procedure. Colour-coded duplex sonography was performed on admission, 30 min after thrombolysis, and at 6 and 24 h after onset of symptoms. Recanalization of the carotid T was classified as complete, partial and absent. Functional outcome was rated with the modified Rankin scale (mRS) at 3 months as favourable (mRS 0–2) or poor (mRS 3–6). Results: Within 6 h, complete or partial recanalization occurred in 1 of 27 patients treated conservatively and in 6 of 15 thrombolysed patients. Intravenous thrombolysis predicted early recanalization also after adjustment for age, sex, cardioembolic stroke aetiology and time to treatment (adjusted odds ratio, OR, 39.7; 95% confidence interval, CI, 2.0–801.7; p = 0.016). An early recanalization was the only selected predictor of a favourable outcome (OR, 13.6; 95% CI, 1.0–179.0; p = 0.047) at regression analysis, and was achieved in 3 thrombolysed patients but in none with conservative medical treatment. Conclusions: In patients treated conservatively, functional outcome is poor and early recanalization rarely occurs. The latter can be achieved by intravenous thrombolysis with a rate comparable to that found at an intra-arterial approach without major intracranial bleeding complications. Early recanalization is associated with a better functional outcome. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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