Intraarterial Therapy for Acute Ischemic Stroke : Investigation of Prognostic Factors

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Background : Intraarterial therapy (IAT) for acute cerebral infarction hasbeen proven to be profitable. However,the criteria for the indications,the choice of thethrombolytic agents, and the use of adjunctive agents are controversial. We retrospectivelyanalyzed the prognostic factors of IAT.Materials and methods: From 1994 to 2003, 28 patients underwent IAT due to middlecerebral artery occlusion (17 women and 11 men ; median age,69 years old). We evaluatedthe following prognostic parameters: institution of treatment, degree of paralysis atvisit, size of high-intensity area on diffusion-weighted images, dose of intraarterialurokinase administration, elapsed time from symptom onset to completion of IAT,presence of penetration of embolus by microcatheter and microguidewire, recanalizationafter IAT, intracranial hemorrhage (ICH) within 24 hours after IAT, and intravenousheparin administration after IAT. The outcome was evaluated at discharge and wasclassified into the following categories according to the modified Rankin Scale: independence(0 to 2), dependence (3 to 5), and death (6).Results: Seven patients were judged to be independent, 16 patients were judged to bedependent, and five patients died. Patients with recanalization after IAT had a betteroutcome than those without (p＜0.05); patients with intracranial hemorrhage had a worseoutcome than those without (p＜0.05); and patients with intravenous heparin administrationafter IAT had a better outcome in activities of daily living than those without (p＜0.05).Conclusion :In addition to ICH and recanalization,our results suggested that intravenousheparin administration after IAT had a favorable effect on patient outcome.
2007-08-25

Intraarterial Therapy for Acute Ischemic Stroke : Investigation of Prognostic Factors

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