Thrombolytic therapy in acute ischemic stroke. A Danish pilot study

Area of Science:

• Neurology
• Radiology
• Cardiovascular Medicine

Background:

• Investigating thrombolytic therapy for acute ischemic stroke.
• Assessing the utility of regional cerebral blood flow (rCBF) measurements.

Purpose of the Study:

• To evaluate the feasibility and safety of thrombolytic therapy.
• To explore the usefulness of rCBF measurements in acute ischemic stroke.

Main Methods:

• 23 patients with acute ischemic stroke received intravenous recombinant tissue plasminogen activator (tPA).
• Thrombolytic therapy initiated 78-355 minutes post-symptom onset.
• rCBF measured using 99mTc-hexamethylpropyleneamine oxime before and after therapy in 12 patients.

Main Results:

• Angiography in 17 patients showed intracranial artery patency in 12, partial occlusion in 3, and total occlusion in 2.
• 10 of 12 patients with rCBF measurements demonstrated reperfusion.
• A significant relationship (P = .015) was found between reperfusion (rCBF) and angiographic patency.
• Early reperfusion correlated with better clinical improvement on the Scandinavian Stroke Scale.

Conclusions:

• rCBF measurements can effectively document acute cerebral ischemia without delaying thrombolytic therapy.
• Repeated rCBF measurements can confirm cerebral reperfusion.
• Early reperfusion following thrombolytic therapy is linked to improved clinical outcomes in acute ischemic stroke.