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Predictors of Clinical Improvement,Angiographic Recanalization, and Intracranial Hemorrhage After Intra-Arterial Thrombolysis for Acute Ischemic Stroke Stroke 30:2094-2100, Suarez,J.I.,et al, 1999 See this aricle in Pubmed Article Abstract Fifty-four patients were treated. There was improvement of >/= 4 points on the National Institutes of Health Stroke Scale from presentation to 24 hours after onset in 43% of the treated patients, and this was related to the severity of t he initial deficit. Forty-eight percent of patients had a Barthel Index score of 95 to 100 at 90 days, and total mortality was 24%. Cranial CT scans revealed intracerebral hemorrhage in 17% of patients in the first 24 hours, and these patients had more severe deficits at presentation. Eighty-seven percent of patients received intravenous heparin after thrombolysis, and 9% of them developed a hemorrhage into infarction. Angiographic recanalization was the rule in complete occlusions of the horizontal p ortion of the middle cerebral artery, but distal carotid occlusions responded less well to thrombolysis. The intra-arterial route for thrombolysis allows for greater diagnostic precision and achievement of a higher concentration of the thrombolytic agent in the vicinity of the clot. Disadvantages of this therapy lie in the cost and delay. Severity of stroke and site of angiographic occlusion may be important predictors of successful treatment.

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(click to filter results - removes previous filter) cerebrovascular accident cerebrovascular accident,acute management of cerebrovascular accident,cost of cerebrovascular accident,severity cerebrovascular accident,thrombolytic agents in treatment fibrinolytic agents fibrinolytic agents,complications fibrinolytic agents,intra-arterial local infusion intracerebral hemorrhage intracranial hemorrhage prognosis recanalization,arterial treatment of neurologic disorder urokinase

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