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Time-Dependent Thrombus Resolution After Tissue-Type Plasminogen Activator in Patients With Stroke and Mice

Authors
 Young Dae Kim  ;  Hyo Suk Nam  ;  Ji Hoe Heo  ;  Hye Sun Lee  ;  Joonsang Yoo  ;  Kijeong Lee  ;  Seung-Hee Yang  ;  Il Kwon  ;  Dongbeom Song  ;  Eung Yeop Kim  ;  Seo Hyun Kim 
Citation
 Stroke, Vol.46(7) : 1877-1882, 2015 
Journal Title
 Stroke 
ISSN
 0039-2499 
Issue Date
2015
Abstract
BACKGROUND AND PURPOSE: We investigated the relationship between the degree of thrombus resolution and the time from stroke onset or thrombus formation to intravenous tissue-type plasminogen activator (tPA) treatment. METHODS: In patients with stroke, we measured thrombus volume on thin-section noncontrast brain computed tomographic scans taken at baseline and 1 hour after tPA administration. We determined the association between the time from symptom onset to tPA treatment and the degree of thrombus resolution. In a C57/BL6 mouse model of FeCl3-induced carotid artery thrombosis, we investigated the effect of tPA administered at different time intervals after thrombus formation, using Doppler-based blood flow measurement. RESULTS: Of 249 patients enrolled, 171 showed thrombus on baseline computed tomography. Thrombus was resolved by ≥50% in 43 patients (25.1%, good volume reduction) and by <50% in 94 patients (55.0%, moderate volume reduction) 1 hour after tPA treatment. In 34 patients (19.9%, nonvolume reduction; either no change or thrombus volume increased), overall thrombus volume increased. The probability of thrombus resolution decreased as the time interval from symptom onset to treatment increased. On multivariate analysis, good volume reduction was independently related with shorter time intervals from symptom onset to tPA treatment (odds ratio, 0.986 per minute saved; 95% confidence interval, 0.974-0.999). In the mouse model, as the interval between thrombus formation and tPA treatment increased, the initiation of recanalization was delayed (P=0.006) and the frequency of final recanalization decreased (P for trends=0.006). CONCLUSIONS: Early administration of tPA after stroke onset is associated with better thrombus resolution.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140613
DOI
10.1161/STROKEAHA.114.008247
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실)
Yonsei Authors
권일(Kwon, Il) ; 김영대(Kim, Young Dae) ; 남효석(Nam, Hyo Suk) ; 송동범(Song, Dong Beom) ; 유준상(Yoo, Joon Sang) ; 이기정(Lee, Ki Jeong) ; 이혜선(Lee, Hye Sun) ; 허지회(Heo, Ji Hoe)
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Full Text
http://stroke.ahajournals.org/content/46/7/1877.long
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