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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Intra-arterial thrombolytic therapy in peri-coronary angiography ischemic stroke

Osama O Zaidat1, Andy P Slivka, Yousef Mohammad

  • 1Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA. ozaidat@hotmail.com

Stroke
|April 2, 2005
PubMed

Insights

Intra-arterial thrombolysis (IAT) after coronary angiography (CA) is safe and effective for stroke. This treatment did not show an increased risk of symptomatic intracranial hemorrhage (ICH) or death compared to existing literature.

Area of Science:

  • Neurology
  • Interventional Cardiology
  • Vascular Neurology

Background:

  • Intra-arterial thrombolysis (IAT) is a potential treatment for stroke occurring after coronary angiography (CA).
  • Concerns exist regarding the increased risk of intracranial hemorrhage (ICH) with IAT.

Purpose of the Study:

  • To evaluate the safety and efficacy of IAT in patients experiencing stroke post-coronary angiography.
  • To assess the incidence of symptomatic ICH and mortality in this patient cohort.

Main Methods:

  • A retrospective analysis of 21 patients treated with IAT across three university hospitals was conducted.
  • Data collected included patient demographics, stroke severity, angiographic findings, thrombolytic agents used, modified Rankin Scale (mRS) scores, ICH occurrence, and mortality rates.

Main Results:

  • Of 21 patients (mean age 71.8 years), 14 had anterior circulation and 7 had posterior circulation occlusions. Mean time-to-therapy was 36 minutes.
  • Good functional recovery (mRS ≤2) was achieved in 48% of patients. Younger age and shorter time-to-IAT correlated with better recanalization and recovery.
  • Symptomatic ICH occurred in 14% of cases, and 19% of patients died.

Conclusions:

  • Peri-coronary angiography IAT is feasible and safe.
  • The study suggests no increased risk of symptomatic ICH or death compared to historical IAT data.
Abstract

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