Intraarterial therapy for acute ischemic stroke: investigation of prognostic factors.

Tomoyuki Noguchi, Takashi Yoshiura, Shuichi Oguri, Akio Hiwatashi, Osamu Togao, Kouji Yamashita, Eiki Nagao, Junji Murakami, Futoshi Mihara, Hiroshi Honda

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Intraarterial therapy (IAT) for acute cerebral infarction has been proven to be profitable. However, the criteria for the indications, the choice of the thrombolytic agents, and the use of adjunctive agents are controversial. We retrospectively analyzed the prognostic factors of IAT. MATERIALS AND METHODS: From 1994 to 2003, 28 patients underwent IAT due to middle cerebral artery occlusion (17 women and 11 men; median age, 69 years old). We evaluated the following prognostic parameters: institution of treatment, degree of paralysis at visit, size of high-intensity area on diffusion-weighted images, dose of intraarterial urokinase administration, elapsed time from symptom onset to completion of IAT, presence of penetration of embolus by microcatheter and microguidewire, recanalization after IAT, intracranial hemorrhage (ICH) within 24 hours after IAT, and intravenous heparin administration after IAT. The outcome was evaluated at discharge and was classified 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 be dependent, and five patients died. Patients with recanalization after IAT had a better outcome than those without (p < 0.05); patients with intracranial hemorrhage had a worse outcome than those without (p < 0.05); and patients with intravenous heparin administration after 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 intravenous heparin administration after IAT had a favorable effect on patient outcome.

Original languageEnglish
Pages (from-to)320-328
Number of pages9
JournalFukuoka igaku zasshi = Hukuoka acta medica
Volume98
Issue number8
Publication statusPublished - Aug 2007

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Stroke
Intracranial Hemorrhages
Therapeutics
Intravenous Administration
Heparin
Fibrinolytic Agents
Middle Cerebral Artery Infarction
Cerebral Infarction
Urokinase-Type Plasminogen Activator
Activities of Daily Living
Embolism
Paralysis

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Intraarterial therapy for acute ischemic stroke : investigation of prognostic factors. / Noguchi, Tomoyuki; Yoshiura, Takashi; Oguri, Shuichi; Hiwatashi, Akio; Togao, Osamu; Yamashita, Kouji; Nagao, Eiki; Murakami, Junji; Mihara, Futoshi; Honda, Hiroshi.

In: Fukuoka igaku zasshi = Hukuoka acta medica, Vol. 98, No. 8, 08.2007, p. 320-328.

Research output: Contribution to journalArticle

Noguchi, T, Yoshiura, T, Oguri, S, Hiwatashi, A, Togao, O, Yamashita, K, Nagao, E, Murakami, J, Mihara, F & Honda, H 2007, 'Intraarterial therapy for acute ischemic stroke: investigation of prognostic factors.', Fukuoka igaku zasshi = Hukuoka acta medica, vol. 98, no. 8, pp. 320-328.
Noguchi, Tomoyuki ; Yoshiura, Takashi ; Oguri, Shuichi ; Hiwatashi, Akio ; Togao, Osamu ; Yamashita, Kouji ; Nagao, Eiki ; Murakami, Junji ; Mihara, Futoshi ; Honda, Hiroshi. / Intraarterial therapy for acute ischemic stroke : investigation of prognostic factors. In: Fukuoka igaku zasshi = Hukuoka acta medica. 2007 ; Vol. 98, No. 8. pp. 320-328.
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T2 - investigation of prognostic factors.

AU - Noguchi, Tomoyuki

AU - Yoshiura, Takashi

AU - Oguri, Shuichi

AU - Hiwatashi, Akio

AU - Togao, Osamu

AU - Yamashita, Kouji

AU - Nagao, Eiki

AU - Murakami, Junji

AU - Mihara, Futoshi

AU - Honda, Hiroshi

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N2 - BACKGROUND: Intraarterial therapy (IAT) for acute cerebral infarction has been proven to be profitable. However, the criteria for the indications, the choice of the thrombolytic agents, and the use of adjunctive agents are controversial. We retrospectively analyzed the prognostic factors of IAT. MATERIALS AND METHODS: From 1994 to 2003, 28 patients underwent IAT due to middle cerebral artery occlusion (17 women and 11 men; median age, 69 years old). We evaluated the following prognostic parameters: institution of treatment, degree of paralysis at visit, size of high-intensity area on diffusion-weighted images, dose of intraarterial urokinase administration, elapsed time from symptom onset to completion of IAT, presence of penetration of embolus by microcatheter and microguidewire, recanalization after IAT, intracranial hemorrhage (ICH) within 24 hours after IAT, and intravenous heparin administration after IAT. The outcome was evaluated at discharge and was classified 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 be dependent, and five patients died. Patients with recanalization after IAT had a better outcome than those without (p < 0.05); patients with intracranial hemorrhage had a worse outcome than those without (p < 0.05); and patients with intravenous heparin administration after 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 intravenous heparin administration after IAT had a favorable effect on patient outcome.

AB - BACKGROUND: Intraarterial therapy (IAT) for acute cerebral infarction has been proven to be profitable. However, the criteria for the indications, the choice of the thrombolytic agents, and the use of adjunctive agents are controversial. We retrospectively analyzed the prognostic factors of IAT. MATERIALS AND METHODS: From 1994 to 2003, 28 patients underwent IAT due to middle cerebral artery occlusion (17 women and 11 men; median age, 69 years old). We evaluated the following prognostic parameters: institution of treatment, degree of paralysis at visit, size of high-intensity area on diffusion-weighted images, dose of intraarterial urokinase administration, elapsed time from symptom onset to completion of IAT, presence of penetration of embolus by microcatheter and microguidewire, recanalization after IAT, intracranial hemorrhage (ICH) within 24 hours after IAT, and intravenous heparin administration after IAT. The outcome was evaluated at discharge and was classified 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 be dependent, and five patients died. Patients with recanalization after IAT had a better outcome than those without (p < 0.05); patients with intracranial hemorrhage had a worse outcome than those without (p < 0.05); and patients with intravenous heparin administration after 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 intravenous heparin administration after IAT had a favorable effect on patient outcome.

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