Local intra-arterial thrombolysis in acute ischemic stroke
Local intra-arterial thrombolysis in acute ischemic stroke
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DOI：
10.1161/01.str.29.9.1894
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发表时间：
1998-09-01
期刊：
影响因子：
8.3
通讯作者：
Schroth, G
中科院分区：
文献类型：
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作者：
Gönner, F;Remonda, L;Schroth, G
背景和目的-我们对局部动脉内溶栓（LIT）治疗的患者的预后因素进行了回顾性分析。本研究的目的是评估使用尿激酶的LIT在前或后循环急性缺血性卒中患者中的安全性和有效性，并确定临床和放射学参数对outcome.Methods-Forty-three患者使用尿激酶（中位剂量，0.75 × 10（6）IU）进行LIT治疗。入院时美国国立卫生研究院卒中量表（NIHSS）评分的中位数为18分（范围：9 - 36分）。9例患者有颈内动脉（伊卡）闭塞，23例大脑中动脉（MCA）闭塞，I或大脑前动脉闭塞，10例基底动脉（BA）闭塞。3个月后评估结果，并归类为良好的兰金量表（RS）评分为0至3和RS评分为4或5和death.Results-Nine（21%）恢复到RS评分0或1，17（40%）的评分为2或3，7（16%）的恐惧4或5。10例患者（23%）死亡。17例MCA闭塞患者（80%）、3例伊卡闭塞患者（33%）和5例BA闭塞患者（50%）的结局良好。良好的结局与初始NIHSS评分
Background and Purpose-We performed a retrospective analysis of the prognostic factors in patients treated with local intra-arterial thrombolysis (LIT). The purpose of this study was to evaluate the safety and efficacy of LIT using urokinase in patients with acute ischemic stroke of the anterior or posterior circulation and to determine the influence of clinical and radiological parameters on outcome.Methods-Forty-three patients were treated with LIT using urokinase (median dose, 0.75 x 10(6) IU). The median National Institutes of Health Stroke Scale (NIHSS) score at hospital admission was 18 (range, 9 to 36). Nine patients had occlusions of the internal carotid artery (ICA), 23 of the middle cerebral artery (MCA), I or the anterior cerebral artery, and 10 of the basilar artery (BA). Outcome was assessed after 3 months and classified as good for Rankin Scale (RS) scores of 0 to 3 and poor for RS scores of 4 or 5 and death.Results-Nine patients (21%) recovered to RS scores 0 or 1, 17 (40%) to scores of 2 or 3, and 7 (16%) to scares of 4 or 5. Ten patients (23%) died. Outcome was good in 17 patients (80%) with MCA occlusions, in 3 patients (33%) with ICA, and in 5 patients (50%) with BA occlusions. Good outcome was associated with an initial NIHSS score of