Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease.
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Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. / Hacke, W; Zeumer, Hermann; Ferbert, A; Brückmann, H; Del Zoppo, G J.
In: STROKE, Vol. 19, No. 10, 10, 1988, p. 1216-1222.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease.
AU - Hacke, W
AU - Zeumer, Hermann
AU - Ferbert, A
AU - Brückmann, H
AU - Del Zoppo, G J
PY - 1988
Y1 - 1988
N2 - In this retrospective analysis we report our treatment experience in 65 consecutive patients with clinical signs of severe brainstem ischemia with angiographically demonstrated thrombotic vertebrobasilar artery occlusions who received either local intra-arterial thrombolytic therapy (urokinase or streptokinase) (43 patients) or conventional therapy (antiplatelet agents or anticoagulants) (22 patients). We analyzed the data with respect to cerebral artery occlusion patterns, posttreatment arterial recanalization, and the clinical categories of favorable/unfavorable outcome and survival/death. In subgroup analyses, recanalization in patients who received thrombolytic therapy correlated significantly with clinical outcome; in 19 of 43 patients, recanalization was demonstrated angiographically, while in 24 patients the occlusion persisted. All patients without recanalization died, but 14 of the 19 patients displaying recanalization survived (p = 0.000007), 10 with a favorable clinical outcome. Only three of the 22 patients who received conventional therapy survived, all with a moderate clinical deficit. When we compared the treatment groups, highly significant differences in both outcome quality (p = 0.017) and survival (p = 0.0005) were found to depend on establishing recanalization. Our data support the concept that technically successful thrombolysis of vertebrobasilar artery occlusions is associated with beneficial clinical outcome.
AB - In this retrospective analysis we report our treatment experience in 65 consecutive patients with clinical signs of severe brainstem ischemia with angiographically demonstrated thrombotic vertebrobasilar artery occlusions who received either local intra-arterial thrombolytic therapy (urokinase or streptokinase) (43 patients) or conventional therapy (antiplatelet agents or anticoagulants) (22 patients). We analyzed the data with respect to cerebral artery occlusion patterns, posttreatment arterial recanalization, and the clinical categories of favorable/unfavorable outcome and survival/death. In subgroup analyses, recanalization in patients who received thrombolytic therapy correlated significantly with clinical outcome; in 19 of 43 patients, recanalization was demonstrated angiographically, while in 24 patients the occlusion persisted. All patients without recanalization died, but 14 of the 19 patients displaying recanalization survived (p = 0.000007), 10 with a favorable clinical outcome. Only three of the 22 patients who received conventional therapy survived, all with a moderate clinical deficit. When we compared the treatment groups, highly significant differences in both outcome quality (p = 0.017) and survival (p = 0.0005) were found to depend on establishing recanalization. Our data support the concept that technically successful thrombolysis of vertebrobasilar artery occlusions is associated with beneficial clinical outcome.
M3 - SCORING: Zeitschriftenaufsatz
VL - 19
SP - 1216
EP - 1222
JO - STROKE
JF - STROKE
SN - 0039-2499
IS - 10
M1 - 10
ER -