J Korean Soc Radiol.  2016 Nov;75(5):346-353. 10.3348/jksr.2016.75.5.346.

Clinical Experience of Intra-Arterial Therapy in Patients with Acute Ischemic Stroke from a Single Institute

Affiliations
  • 1Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.
  • 2Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. okjun77@cha.ac.kr
  • 3Institute for Clinical Research, School of Medicine, CHA University, Seongnam, Korea.
  • 4Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

Abstract

PURPOSE
To compare the efficacy and safety between intra-arterial therapy (IAT) and intra-venous and intra-arterial combined therapy (IVIACT) in patients with acute ischemic stroke in the anterior circulation territory.
MATERIALS AND METHODS
Forty-one patients treated with IAT using Solitaire were retrospectively reviewed. Nineteen patients were treated with IAT, twenty-two patients were treated with IVIACT, and ten patients of the forty-one patients were managed with multimodal treatment like stent, balloon angioplasty etc. We investigated the rate of recanalization and hemorrhage, NIH stroke scale and 3-month modified Rankin Scale.
RESULTS
The overall recanalization rate was 93% and symptomatic ICH occurred in 10% of the patients. There was no difference in hemorrhage, recanalization rate, and early improvement between IAT and IVIACT. Good outcome was more frequently observed in 59% of the patients with IVIACT than 36% of the patients treated with IAT without any significant difference. The patients managed with multimodal treatment did not show any significant hemorrhage outcome.
CONCLUSION
IAT using Solitaire is a useful treatment method without high risk in patients with acute ischemic stroke in the anterior circulation territory. Also, IVIACT and multimodal treatment might be considered as reasonable therapeutic options in these patients.


MeSH Terms

Angioplasty, Balloon
Combined Modality Therapy
Hemorrhage
Humans
Mechanical Thrombolysis
Methods
Retrospective Studies
Stents
Stroke*
Tissue Plasminogen Activator
Tissue Plasminogen Activator

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