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Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
Published on: September 25, 2016
Thrombolytic therapy for cerebral embolism.
1Department of Surgical Neuroangiography, Neurosurgery, Nakamura Memorial Hospital; Sapporo, Japan.
Summary
Thrombolytic therapy shows promise for cerebral embolism, particularly for middle cerebral artery (MCA) and basilar artery occlusions. Pre-treatment cerebral blood flow (CBF) measurement aids in assessing ischemia severity and preventing complications.
Area of Science:
- Neurology
- Vascular Medicine
- Interventional Radiology
Background:
- Cerebral embolism poses a significant risk for stroke.
- Thrombolytic therapy is a potential treatment, but its efficacy varies by occlusion site.
- Predicting treatment outcomes and complications is crucial.
Purpose of the Study:
- To evaluate the prognosis of thrombolytic therapy for cerebral embolism based on occlusion site.
- To assess the role of pre-treatment cerebral blood flow (CBF) measurement in supratentorial cerebral embolism.
- To compare thrombolytic therapy outcomes with conservative medical management.
Main Methods:
- Analysis of 56 cases of thrombolysis for cerebral embolism.
- Comparison of outcomes between thrombolysis and conservative medical therapy groups.
- Evaluation of pre-treatment CBF measurements for predicting outcomes and complications.
Main Results:
- Thrombolysis was discontinued for internal carotid artery (ICA) embolism due to poor collateral circulation.
- Middle cerebral artery (MCA) embolism showed significantly better outcomes with thrombolysis compared to conservative therapy.
- Basilar artery embolism demonstrated the highest effectiveness with thrombolysis, despite a high mortality rate.
- Pre-treatment CBF measurement proved useful in estimating ischemia severity and avoiding hemorrhagic complications.
Conclusions:
- Thrombolytic therapy is a viable option for specific cerebral embolism sites, notably MCA and basilar artery occlusions.
- Pre-treatment CBF measurement is critical for optimizing thrombolytic therapy and mitigating risks.
- Individualized treatment strategies based on occlusion site and CBF are essential for improving patient prognosis.
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