Impacts of rapid recanalization and collateral circulation on clinical outcome after intraarterial thrombolysis.
Impacts of rapid recanalization and collateral circulation on clinical outcome after intraarterial thrombolysis.
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DOI：
10.5853/jos.2015.17.1.76
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发表时间：
2015-01
影响因子：
8.2
通讯作者：
Kim J
中科院分区：
文献类型：
--
作者：
Jeong HS;Kwon HJ;Song HJ;Koh HS;Kim YS;Lee JH;Shin JE;Lee SH;Kim J
急性缺血性脑卒中伴侧支循环患者行动脉内溶栓治疗后，快速再通可能改善临床结局。我们确定了快速再通和侧支循环是否影响IAT后的临床结局。我们回顾性评价了134例接受IAT治疗颅内动脉闭塞的连续患者的临床和影像学资料。在缺血半球侧支循环评分为差（0/1美国介入和治疗神经放射学会标准）或好（2-4）的患者中，计算症状发作至IAT后再通的时间间隔（发作至再通时间），作为良好临床结局概率的估计值（改良兰金量表0-2）。比较了IAT前后美国国立卫生研究院卒中量表（NHISS）评分和出院后3个月改良Rankins量表评分的变化与发病至再通时间。在侧支循环良好的患者中，临床结局良好概率为0.5的估计发作至再通时间为347分钟;侧支循环不良的患者中，临床结局良好概率为0.2的估计发作至再通时间为172分钟。根据发病至再通时间进行的结局分析显示，再通时间<6小时的患者NHISS评分较低（发作至再通时间<4.5、4.5-6、>6小时，未再通：出院时的良好临床结局百分比（分别为5.1、6.9、11.9和19.8）和IAT后3个月的良好临床结局百分比（分别为69%、66.7%、21.9%和0%）较高。预期IAT后良好临床结局的高概率的时间窗高度依赖于侧支循环。
Rapid recanalization might improve clinical outcomes after intraarterial thrombolysis (IAT) for acute ischemic stroke patients with collateral circulation. We determined whether rapid recanalization and collateral circulation affect clinical outcomes after IAT. We retrospectively evaluated the clinical and radiological data of 134 consecutive patients who underwent IAT for intracranial artery occlusion. The interval from symptom onset to recanalization after IAT (onset-to-recanalization time) as an estimate of the probability of good clinical outcome (modified Rankin scale 0-2) was calculated in patients with collateral circulation in the ischemic hemisphere, which was rated poor (0/1 American Society of Interventional and Therapeutic Neuroradiology criteria) or good (2-4). Changes in National Institute of Health Stroke Scale (NHISS) score before and after IAT and modified Rankins scale scores 3 months after discharge were compared with respect to onset-to-recanalization time. In patients with good collateral circulation, the estimated onset-to-recanalization time for a 0.5 probability of a good clinical outcome was 347 minutes; with poor collateral circulation, it was 172 minutes for a 0.2 probability of good clinical outcome. Outcome analyses according to onset-to-recanalization time showed patients recanalized <6 hours had lower NHISS scores (<4.5, 4.5-6, >6 hours of onset-to-recanalization time, and non-recanalization: 5.1, 6.9, 11.9, and 19.8, respectively) at discharge and higher percentages of good clinical outcome (69%, 66.7%, 21.9%, and 0%, respectively) 3 months after IAT. The time window to expect a high probability of a good clinical outcome after IAT is highly dependent on the collateral circulation.
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影响因子：
11
作者：
Bang, O. Y.;Saver, J. L.;Liebeskind, D. S.
通讯作者：
Liebeskind, D. S.
DOI：
10.1016/s1474-4422(14)70066-3
发表时间：
2014-06
期刊：
The Lancet. Neurology
影响因子：
--
作者：
Khatri P;Yeatts SD;Mazighi M;Broderick JP;Liebeskind DS;Demchuk AM;Amarenco P;Carrozzella J;Spilker J;Foster LD;Goyal M;Hill MD;Palesch YY;Jauch EC;Haley EC;Vagal A;Tomsick TA;IMS III Trialists
通讯作者：
IMS III Trialists
DOI：
10.1056/nejmoa1214300
发表时间：
2013-03-07
期刊：
The New England journal of medicine
影响因子：
--
作者：
Broderick JP;Palesch YY;Demchuk AM;Yeatts SD;Khatri P;Hill MD;Jauch EC;Jovin TG;Yan B;Silver FL;von Kummer R;Molina CA;Demaerschalk BM;Budzik R;Clark WM;Zaidat OO;Malisch TW;Goyal M;Schonewille WJ;Mazighi M;Engelter ST;Anderson C;Spilker J;Carrozzella J;Ryckborst KJ;Janis LS;Martin RH;Foster LD;Tomsick TA;Interventional Management of Stroke (IMS) III Investigators
通讯作者：
Interventional Management of Stroke (IMS) III Investigators
影响因子：
8.3
作者：
Rha, Joung-Ho;Saver, Jeffrey L.
通讯作者：
Saver, Jeffrey L.
影响因子：
8.3
作者：
Langer, David;Alexander, Michael;Gomes, Joao
通讯作者：
Gomes, Joao