Utility of a rescue endovascular therapy for the treatment of
major strokes refractory to full-dose intravenous thrombolysis

J 2014

Utility of a rescue endovascular therapy for the treatment of major strokes refractory to full-dose intravenous thrombolysis

VANÍČEK, Jiří, Martin BULIK, Jaroslav BRICHTA a Radim JANČÁLEK

Základní údaje

Originální název

Utility of a rescue endovascular therapy for the treatment of major strokes refractory to full-dose intravenous thrombolysis

Autoři

VANÍČEK, Jiří (203 Česká republika, garant, domácí), Martin BULIK (203 Česká republika, domácí), Jaroslav BRICHTA (203 Česká republika) a Radim JANČÁLEK (203 Česká republika, domácí)

Vydání

BRITISH JOURNAL OF RADIOLOGY, LONDON, BRITISH INST RADIOLOGY, 2014, 0007-1285

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30000 3. Medical and Health Sciences

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 2.026

Kód RIV

RIV/00216224:14110/14:00077147

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1259/bjr.20130545

UT WoS

000334291900006

Klíčová slova anglicky

ACUTE ISCHEMIC-STROKE; MECHANICAL THROMBECTOMY; RECANALIZATION; VALIDATION; RETRIEVER

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 6. 11. 2014 15:31, Soňa Böhmová

Anotace

V originále

Objective: Large artery occlusion (LAO) in patients with major stroke predicts poor revascularization by intravenous thrombolysis (IVT) and more likely results in a poor outcome. We focused on the effects of intra- arterial thrombolysis (IAT) and endovascular mechanical recanalization (EMR) as rescue therapies in major strokes refractory to IVT. Methods: A retrospective analysis of 87 patients (National Institutes of Health Stroke Scale >20), who did not respond to full-dose IVT due to LAO, was performed based on their endovascular therapy status. IAT was performed as an intraclot infusion of alteplase, and EMR was provided by the Solitaire device (TM) (Covidien, Dubin, Ireland). The recanalization and 3-month outcome rates after IAT/EMR were correlated with a group of patients who were scheduled to receive endovascular treatment but who underwent only IVT. Results: We achieved successful recanalization by IAT and EMR in 68.7% and 76.1% of patients, respectively. Despite no significant differences in mortality between IAT and EMR, a trend towards better outcomes after IAT and a statistically significant increase for outcome-modified Rankin scale (mRS) 0-3 (45.7%) and mRS 0-2 (34.9%) after EMR was noted when compared with IVT. The degree of recanalization did not correlate with the functional results except for the good-moderate outcome after successful recanalization by EMR. Conclusion: EMR by the Solitaire device is a safe and beneficial method for the rescue treatment of patients with major stroke whose neurological status does not improve and who fail to recanalize the LAO after a 1-h full dose of IVT. Advances in knowledge: The article verifies efficiency of the Solitaire device in major strokes.

Citovat

VANÍČEK, Jiří, Martin BULIK, Jaroslav BRICHTA a Radim JANČÁLEK. Utility of a rescue endovascular therapy for the treatment of major strokes refractory to full-dose intravenous thrombolysis. BRITISH JOURNAL OF RADIOLOGY. LONDON: BRITISH INST RADIOLOGY, 2014, roč. 87, č. 1036, s. "20130545", 9 s. ISSN 0007-1285. Dostupné z: https://dx.doi.org/10.1259/bjr.20130545.

@article{1205130,
   author = {Vaníček, Jiří and Bulik, Martin and Brichta, Jaroslav and Jančálek, Radim},
   article_location = {LONDON},
   article_number = {1036},
   doi = {http://dx.doi.org/10.1259/bjr.20130545},
   keywords = {ACUTE ISCHEMIC-STROKE; MECHANICAL THROMBECTOMY; RECANALIZATION; VALIDATION; RETRIEVER},
   language = {eng},
   issn = {0007-1285},
   journal = {BRITISH JOURNAL OF RADIOLOGY},
   title = {Utility of a rescue endovascular therapy for the treatment of major strokes refractory to full-dose intravenous thrombolysis},
   volume = {87},
   year = {2014}
}

TY  - JOUR
ID  - 1205130
AU  - Vaníček, Jiří - Bulik, Martin - Brichta, Jaroslav - Jančálek, Radim
PY  - 2014
TI  - Utility of a rescue endovascular therapy for the treatment of major strokes refractory to full-dose intravenous thrombolysis
JF  - BRITISH JOURNAL OF RADIOLOGY
VL  - 87
IS  - 1036
SP  - "20130545"
EP  - "20130545"
PB  - BRITISH INST RADIOLOGY
SN  - 00071285
KW  - ACUTE ISCHEMIC-STROKE
KW  - MECHANICAL THROMBECTOMY
KW  - RECANALIZATION
KW  - VALIDATION
KW  - RETRIEVER
N2  - Objective: Large artery occlusion (LAO) in patients with major stroke predicts poor revascularization by intravenous thrombolysis (IVT) and more likely results in a poor outcome. We focused on the effects of intra- arterial thrombolysis (IAT) and endovascular mechanical recanalization (EMR) as rescue therapies in major strokes refractory to IVT. Methods: A retrospective analysis of 87 patients (National Institutes of Health Stroke Scale >20), who did not respond to full-dose IVT due to LAO, was performed based on their endovascular therapy status. IAT was performed as an intraclot infusion of alteplase, and EMR was provided by the Solitaire device (TM) (Covidien, Dubin, Ireland). The recanalization and 3-month outcome rates after IAT/EMR were correlated with a group of patients who were scheduled to receive endovascular treatment but who underwent only IVT. Results: We achieved successful recanalization by IAT and EMR in 68.7% and 76.1% of patients, respectively. Despite no significant differences in mortality between IAT and EMR, a trend towards better outcomes after IAT and a statistically significant increase for outcome-modified Rankin scale (mRS) 0-3 (45.7%) and mRS 0-2 (34.9%) after EMR was noted when compared with IVT. The degree of recanalization did not correlate with the functional results except for the good-moderate outcome after successful recanalization by EMR. Conclusion: EMR by the Solitaire device is a safe and beneficial method for the rescue treatment of patients with major stroke whose neurological status does not improve and who fail to recanalize the LAO after a 1-h full dose of IVT. Advances in knowledge: The article verifies efficiency of the Solitaire device in major strokes.
ER  -

VANÍČEK, Jiří, Martin BULIK, Jaroslav BRICHTA a Radim JANČÁLEK. Utility of a rescue endovascular therapy for the treatment of major strokes refractory to full-dose intravenous thrombolysis. \textit{BRITISH JOURNAL OF RADIOLOGY}. LONDON: BRITISH INST RADIOLOGY, 2014, roč.~87, č.~1036, s.~''20130545'', 9 s. ISSN~0007-1285. Dostupné z: https://dx.doi.org/10.1259/bjr.20130545.

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