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@article{837065,
author = {Mikulík, Robert and Goldemund, David and Reif, Michal and Aulický, Petr and Krupa, Petr},
article_location = {USA},
article_number = {3},
doi = {http://dx.doi.org/10.1161/STROKEAHA.108.532572},
keywords = {CT angiography; outcome; stroke care; thrombolysis},
language = {eng},
issn = {0039-2499},
journal = {Stroke},
title = {Outcome of Patients With Negative CT Angiography Results for Arterial Occlusion Treated With Intravenous Thrombolysis},
volume = {40},
year = {2009}
}
TY - JOUR
ID - 837065
AU - Mikulík, Robert - Goldemund, David - Reif, Michal - Aulický, Petr - Krupa, Petr
PY - 2009
TI - Outcome of Patients With Negative CT Angiography Results for Arterial Occlusion Treated With Intravenous Thrombolysis
JF - Stroke
VL - 40
IS - 3
SP - 868-872
EP - 868-872
SN - 00392499
KW - CT angiography
KW - outcome
KW - stroke care
KW - thrombolysis
N2 - Background and Purpose - Stroke patients without evidence of arterial occlusion may not be suitable candidates for thrombolytic therapy. In our study, we investigated the outcomes of patients with negative CT angiography results for arterial occlusion. Methods - The study included patients treated within 3 hours after symptom onset with intravenous thrombolysis for significant neurological deficit between August 2003 and June 2007. All of the patients were documented with negative CT angiography results for arterial occlusion by independent reviews. Outcome measurements included modified Rankin score at 3 months, incidence of intracranial hemorrhage, and infarction volume on control CT. The predictors of unfavorable outcome (modified Rankin score, 2 - 6) were identified by multivariate logistic regression. Results - Altogether, 173 patients received intravenous thrombolysis; of those, 138 underwent CT angiography. The CT angiography results were negative for arterial occlusion in 39 (28%) of the patients: mean age, 71+/-10 years; 16 (41%) female; median baseline NIHSS, 11. At 3 months, modified Rankin score of 0 to 1 was achieved in 18 (46%) of the patients; 6 (15%) died; and 3 (8%) had symptomatic parenchymal hemorrhage. The median infarct volume was 1.5 cm(3). The independent predictors of unfavorable clinical outcome were higher age (OR, 1.1; 95% CI, 1.01-1.27), and baseline NIHSS more than 12;2 (OR, 18.8; 95% CI, 1.4 to 261). One patient had encephalitis diagnosed. Conclusions - Negative baseline CT angiography is not uncommon. The risk of intracerebral hemorrhage after thrombolytic therapy for patients without evidence of arterial occlusion is similar to the risk carried in an unselected patient population. Given the prognosis, thrombolytic therapy seems justified; however, etiology other than stroke should be considered.
ER -
MIKULÍK, Robert, David GOLDEMUND, Michal REIF, Petr AULICKÝ and Petr KRUPA. Outcome of Patients With Negative CT Angiography Results for Arterial Occlusion Treated With Intravenous Thrombolysis. \textit{Stroke}. USA, vol.~40, No~3, p.~868-872. ISSN~0039-2499. doi:10.1161/STROKEAHA.108.532572. 2009.
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