Related Experiment Video
Updated: Aug 8, 2026
09:11
Embolic Middle Cerebral Artery Occlusion (MCAO) for Ischemic Stroke with Homologous Blood Clots in Rats
Published on: September 17, 2014
Acute anterior circulation stroke: recanalization using clot angioplasty
Cheemun Lum1, Peter K Stys, Matthew J Hogan
1Department of Diagnostic Imaging-Neuroradiology Section, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
Summary
Endovascular clot disruption using balloon angioplasty combined with thrombolysis offers a promising approach for acute stroke. This technique effectively recanalized vessels, potentially shortening treatment times and improving outcomes in select stroke patients.
Area of Science:
- Neuroendovascular Interventions
- Cerebrovascular Diseases
- Acute Stroke Management
Background:
- Traditional thrombolysis with tissue plasminogen activator (tPA) may be insufficient for large clots in acute stroke.
- Recanalization of acutely occluded internal carotid arteries (ICA) and middle cerebral arteries (MCA) is crucial.
Observation:
- A retrospective review of nine acute stroke patients treated with intracranial balloon angioplasty and thrombolysis was conducted.
- Patients presented with large vessel occlusions (terminal ICA, M1, or proximal M2 MCA) within six hours of symptom onset.
Findings:
- Balloon angioplasty combined with thrombolysis achieved recanalization in 89% of patients (TIMI 2 or 3).
- The average time from CT imaging to recanalization was 2.1 hours, with a mean symptom onset to recanalization time of 4.1 hours.
- Good outcomes (modified Rankin Scale 0-2) were observed in 56% of patients, with a low rate of symptomatic intracranial hemorrhage.
Implications:
- Intracranial balloon angioplasty is an effective complementary procedure for tPA-resistant clots in acute stroke.
- This endovascular technique can potentially shorten recanalization times and improve clinical outcomes in carefully selected patients.
- The described angioplasty technique demonstrates a very low complication rate.
