Current Status of Recanalization Therapy in Acute Ischemic Stroke with Symptomatic Intracranial Arterial Occlusion in Korea

Min Uk JangJeong-Ho HongJihoon KangBeom Joon KimMoon-Ku HanByung-Chul LeeKyung-Ho YuMi Sun OhKeun-Sik HongYong-Jin ChoJong-Moo ParkKyusik KangJae Kwan ChaDae-Hyun KimTai Hwan ParkKyung Bok LeeSoo Joo LeeYoungchai KoJun LeeKi-Hyun ChoJoon-Tae KimJuneyoung LeeJi Sung LeeHee-Joon Bae
Dept. of Neurology (신경과학)
Issue Date
Journal of Stroke and Cerebrovascular Diseases, Vol.23(5) : e339-e346, 2014
Background Recent methodological advances in recanalization therapy may alter recanalization strategies and clinical outcomes in patients with symptomatic occlusion of intracranial cerebral arteries. However, few studies have analyzed these changes at a national level, with none conducted in Korea. Methods On the basis of a prospective multicenter stroke registry database in Korea, 642 consecutive patients hospitalized within 12 hours of the onset with symptomatic occlusion of intracranial major cerebral arteries between March 2010 and November 2011 were identified. Recanalization therapy was used in 48% (n = 307) of patients; intravenous thrombolysis only (IVT) in 46%, intra-arterial thrombolysis only (IAT) in 16%, and combined thrombolysis (CMT) in 38%. Of the 166 patients treated by IAT or CMT, the Penumbra system or the Solitaire was used in 58% of patients. Results Early neurologic improvement (ENI), 3-month modified Rankin scale (mRS) score of 2 or less, and symptomatic hemorrhagic transformation (SHT) were observed in 43%, 39%, and 9% of the patients in the IVT group; 52%, 27%, and 12% of the patients in the IAT group; and 54%, 39%, and 12% of the patients in the CMT group, respectively. Compared with no treatment, adjusted odd ratios (95% confidence intervals) of recanalization therapy were 1.59 (1.04-2.42) for ENI, 1.37 (.81-2.30) for 3-month mRS score of 2 or less, and 2.58 (1.12-5.91) for SHT. Conclusions The variety and active use of endovascular approaches were quite noticeable. As a whole, recanalization therapy tended to contribute to favorable outcomes despite a significant increase of symptomatic hemorrhage. Key Words Recanalization therapy; endovascular treatment; thrombolysis; acute ischemic stroke; intracranial arterial occlusion; Korea; outcome; registry
Recanalization therapyendovascular treatmentthrombolysisacute ischemic strokeintracranial arterial occlusionKoreaoutcomeregistry
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