Related Experiment Video

Updated: May 28, 2026

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

Systemic thrombolysis in patients with acute ischemic stroke and Internal Carotid ARtery Occlusion: the ICARO study

Maurizio Paciaroni1, Clotilde Balucani, Giancarlo Agnelli

  • 1Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Perugia 06126, Italy. mpaciaroni@med.unipg.it

Stroke
|October 29, 2011
PubMed

Insights

Intravenous thrombolytic therapy for internal carotid artery occlusion stroke improves patient outcomes but increases risks of death and bleeding. This treatment offers a significant reduction in long-term disability for stroke patients.

Area of Science:

  • Neurology
  • Cardiovascular Research
  • Emergency Medicine

Background:

  • The efficacy of intravenous thrombolytic therapy for acute ischemic stroke due to internal carotid artery (ICA) occlusion is not well-established.
  • Investigating this treatment's impact is crucial for optimizing stroke care.

Purpose of the Study:

  • To assess the effectiveness and safety of intravenous recombinant tissue-type plasminogen activator (rt-PA) in patients with acute ischemic stroke caused by ICA occlusion.

Main Methods:

  • A multicenter, case-control study (ICARO) compared patients receiving rt-PA within 4.5 hours of symptom onset (cases) to matched controls not receiving rt-PA.
  • Outcomes included disability at 90 days (modified Rankin Scale) and safety events like death and intracranial bleeding.

Main Results:

  • 253 cases and 253 controls were analyzed.
  • Favorable outcomes (mRS 0-2) were observed in 28.9% of cases vs. 20.6% of controls (OR, 1.80; P=0.037).
  • Death occurred in 25.7% of cases vs. 15.4% of controls (OR, 2.28; P=0.001), with a trend towards more fatal bleeds in cases (2.8% vs. 0.4%).

Conclusions:

  • Intravenous thrombolytic therapy significantly reduces long-term dependency in patients with stroke due to ICA occlusion.
  • This clinical benefit is associated with an increased risk of mortality and intracranial hemorrhage.
Abstract

More Related Videos

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Related Concept Videos

Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...