Efficiency of Intravenous Thrombolytic Therapy in Isolated Middle Cerebral Artery Occlusions: A Computed Tomography Angiography Study/Izole Orta Serebral Arter Okluzyonlarinda Intravenoz Trombolitik Tedavinin Yeri: Bilgisayarli Tomografi Anjiyografi Calismasi

Citation metadata

Authors: Ezgi Sezer Eryildiz and Atilla Ozcan Ozdemir
Date: Mar. 2018
From: Turkish Journal of Neurology(Vol. 24, Issue 1)
Publisher: Galenos Yayinevi Tic. Ltd.
Document Type: Report
Length: 3,479 words

Main content

Abstract :

Objective: We aimed to evaluate the outcomes of two groups of patients with acute ischemic stroke who were treated with intravenous recombinant tissueplasminogen activator (IV rt-PA); those with isolated middle cerebral artery (MCA) occlusion and those without any large vessel occlusion. Materials and Methods: Data of patients treated with IV rt-PA within 4.5 hours of symptom onset between March 2015 and January 2017 were retrospectively analyzed. Patients were divided into two groups; those with isolated MCA occlusion and those with no large vessel occlusion. Large vessel occlusion was detected with contrast-enhanced computed tomography angiography performed before IV rt-PA. Additionally, demographic and clinical data of the patients were analyzed. The clinical outcomes of the patients were determined using the modified Rankin Scale (mRS) score at 3 months after treatment. Results: A total of 69 patients were included in the study. Isolated MCA occlusion was observed in 28 (40.6%) patients. The rate of very good outcome (mRS 0-1) was 46.4%, whereas the rate of poor outcome (mRS 3-6) was 42.9% in the group with isolated MCA occlusion. Moreover, in the other group, the rate of very good outcome and poor outcome were 65.9% and 26.8%, respectively. Conclusion: In acute ischemic stroke with isolated MCA occlusion, due to the favorable outcomes of the patients, IV rt-PA continues to be the best treatment option in cases where endovascular treatment options cannot be performed and it should be applied by physicians in appropriate cases without delay. Keywords: Acute stroke, middle cerebral artery, occlusion, intravenous recombinant tissue-plasminogen activator, outcome Amac: Intravenoz rekombinant doku-plazminojen aktivatoru (IV rt-PA) uygulanan akut iskemik inme hastalarinda izole orta serebral arter (OSA) okluzyonu olan ve herhangi bir buyuk damar okluzyonu olmayan iki grubun tedavi yanitlarini ve sonlanimlarini degerlendirmeyi amacladik. Gerec ve Yontem: Inme merkezimizde Mart 2015-Ocak 2017 tarihleri arasinda semptom sonrasi ilk 4,5 saat icerisinde IV rt-PA uygulanan hastalarin verileri, izole OSA okluzyonu olanlar ve herhangi bir buyuk damar okluzyonu olmayanlar olarak ikiye ayrilarak retrospektif olarak analiz edildi. Buyuk damar okluzyonu; IV rt-PA oncesi yapilan kontrastli bilgisayarli tomografi anjiyografi ile saptandi. Bunun yaninda hastalarin demografik ve klinik verileri degerlendirildi. Hastalarin klinik sonlanimlari ise tedavinin 3. ayinda hesaplanan 'the modified Rankin Scale' (mRS) skorlari ile belirlendi. Bulgular: Toplam 69 hasta calismaya dahil edilmis olup, bunlarin 28'inde (%40,6) izole OSA okluzyonu saptandi. Izole OSA okluzyonu olan grupta cok iyi sonlanim (mRS 0-1) orani %46,4 bulunurken, kotu sonlanim (mRS 3-6) orani %42,9 olarak bulundu. Herhangi bir buyuk damar okluzyonu olmayan grupta ise cok iyi sonlanim orani %65,9 bulunurken, kotu sonlanim orani %26,8 olarak bulundu. Sonuc: Akut iskemik inmede izole OSA okluzyonu varliginda, IV rt-PA; sagladigi iyi sonlanim oranlari ile endovaskuler tedavi seceneklerinin uygulanamadigi durumlarda en iyi tedavi secenegi olmayi surdurmektedir ve uygun hastalarda klinisyen tarafindan vakit kaybetmeksizin uygulanmalidir. Anahtar Kelimeler: Akut inme, orta serebral arter, okluzyon, intravenoz rekombinant doku-plazminojen aktivatoru, sonlanim

Source Citation

Source Citation
Eryildiz, Ezgi Sezer, and Atilla Ozcan Ozdemir. "Efficiency of Intravenous Thrombolytic Therapy in Isolated Middle Cerebral Artery Occlusions: A Computed Tomography Angiography Study/Izole Orta Serebral Arter Okluzyonlarinda Intravenoz Trombolitik Tedavinin Yeri: Bilgisayarli Tomografi Anjiyografi Calismasi." Turkish Journal of Neurology, vol. 24, no. 1, 2018, p. 38+. Accessed 15 Jan. 2021.
  

Gale Document Number: GALE|A534100278