Reperfusion Rates Following Intra-Arterial Thrombolysis for Acute Ischemic Stroke: The Influence of the Method for Alteplase Delivery

Christoforidis, Gregory A.; Slivka, A.; Mohammad, Yousef; Karakasis, Christopher; Kontzialis, Marinos; Khadir, Mohammed Mohsin

doi:10.3174/ajnr.a2973

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…The appearance of the SDAF sign on advanced-stage cerebrovascular arteriograms obtained before intra-arterial thrombolytic treatment (IAT) is known to be a statistically significant predictor for recanalization [ 34 ]. IAT can achieve more favorable recanalization in patients with the SDAF sign than in patients without it.…”

Section: Discussionmentioning

confidence: 99%

“…The calcification at the occluded segment was evaluated on preoperative CTA original images and MPR images and categorized as no evident calcification or the presence of calcification. The SDAF sign was defined as slow antegrade contrast opacification distal to the occlusion site on the delayed images of the presenting arteriogram, as previously described by Christoforidis et al [ 34 ], and categorized as no SDAF sign or presence of SDAF sign. The presence of bridging collateral vessels was angiographically defined as a plexus of micro-vessel channels bridging between the vessel proximal and distal to the occlusion, which allowed antegrade opacification of the patent vessels distal to the occlusion [ 35 , 36 ].…”

Section: Methodsmentioning

confidence: 99%

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Predictors of successful endovascular recanalization in patients with symptomatic nonacute intracranial large artery occlusion

Yan,

Feng,

et al. 2023

BMC Neurol

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Background Endovascular recanalization in patients with symptomatic nonacute intracranial large artery occlusion (ILAO) has been reported to be feasible, but technically challenging. This study aimed to determine the predictors of successful endovascular recanalization in patients with symptomatic nonacute ILAO. Methods The outcomes of endovascular recanalization attempts performed in 70 consecutive patients showing symptomatic nonacute ILAO with hemodynamic cerebral ischemia between January 2016 to December 2022 were reviewed. Potential variables, including clinical and radiological characteristics related to technical success, were collected. Univariate analysis and multivariate logistic regression were performed to identify predictors of successful recanalization for nonacute ILAO. Results Technically successful recanalization was achieved in 57 patients (81.4%). The periprocedural complication rate was 21.4% (15 of 70), and the overall 30-day morbidity and mortality rates were 7.1% (5 of 70) and 2.9% (2 of 70), respectively. Univariate analysis showed that successful recanalization was associated with occlusion duration, stump morphology, occlusion length, slow distal antegrade flow sign, and the presence of bridging collateral vessels. Multivariate analysis showed that occlusion duration ≤ 3 months (odds ratio [OR]: 22.529; 95% confidence interval [CI]: 1.636-310.141), tapered stump (OR: 7.498; 95% CI: 1.533–36.671), and occlusion length < 10 mm (OR: 7.049; 95% CI: 1.402–35.441) were independent predictive factors for technical success of recanalization. Conclusions Occlusion duration ≤ 3 months, tapered stump, and occlusion length < 10 mm were independent positive predictors of technical success of endovascular recanalization for symptomatic nonacute ILAO. These findings may help predict the likelihood of successful recanalization in patients with symptomatic nonacute ILAO and also provide a reference for the selection of appropriate patients. Further prospective and multicenter studies are required to validate our findings.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Predictors of successful endovascular recanalization in patients with symptomatic nonacute intracranial large artery occlusion

Yan,

Feng,

et al. 2023

BMC Neurol

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Adjuvant intra-arterial thrombolysis during mechanical thrombectomy is an effective means of improving outcomes for patients with large vessel occlusion stroke: A systematic review and meta-analysis

Chang

2023

Clinical Neurology and Neurosurgery

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Reperfusion Rates Following Intra-Arterial Thrombolysis for Acute Ischemic Stroke: The Influence of the Method for Alteplase Delivery

Abstract: BACKGROUND AND PURPOSE:Because alteplase does not penetrate thrombus effectively, this study examined whether a method thought to maximize surface distribution of alteplase on the offending thrombus during IATT would result in greater reperfusion rates in acute ischemic stroke.

Cited by 2 publications

References 19 publications

Predictors of successful endovascular recanalization in patients with symptomatic nonacute intracranial large artery occlusion

Predictors of successful endovascular recanalization in patients with symptomatic nonacute intracranial large artery occlusion

Adjuvant intra-arterial thrombolysis during mechanical thrombectomy is an effective means of improving outcomes for patients with large vessel occlusion stroke: A systematic review and meta-analysis

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