The efficacy of local intraarterial thrombolysis for internal carotid artery occlusion and middle cerebral artery occlusion: Therapeutic rresult and clinical outcome:Therapeutic Rresult and Clinical Outcome
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Recent papers have reported the effectiveness of local intraarterial thrombolysis (LIT) on acute occlusion of major cerebral arteries, especially on middle cerebral artery occlusion (MCO), but it is not fully accepted in internal carotid artery occlusion (ICO). ICO, particularly with poor collateral flow, may be fatal if recanalization is not be achieved. At our institute, 32 LITs were performed with alteplase in the last 5 five years and the efficacy of LIT has been studied for ICO in 15 and MCO for 17 of these cases. Compared to MCO, ICO proved worse conscious state and lower regional cerebral blood flow (rCBF) in the middle cerebral artery area measured by xenon-enhanced computed tomography. There is no significant difference between groups on recanalization or intracranial hemorrhage. The percentage of brain death was 60% in ICO and 18% in MCO, and mortality in hospital was 80% and 41% (p<0.05). Although ICO is fatal, with successful LIT, recanalization without intracranial hemorrhage, patients escape brain death. This is statistically significant (p<0.05) in ICO patients but not in MCO patients. Conclusion: ICO patients are more severely compromised than MCO patients in consciousness, rCBF of the ischemic area and mortality. A significant relationship between the result of LIT and clinical outcome has been proven only in ICO.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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