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Rescue localized intra-arterial thrombolysis for hyperacute MCA ischemic stroke patients after early non-responsive intravenous tissue plasminogen activator therapy

DC Field Value Language
dc.contributor.author김동익-
dc.contributor.author김동준-
dc.contributor.author이경열-
dc.contributor.author한상원-
dc.contributor.author허지회-
dc.date.accessioned2017-05-08T08:00:04Z-
dc.date.available2017-05-08T08:00:04Z-
dc.date.issued2005-
dc.identifier.issn0028-3940-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/147644-
dc.description.abstractThe outcome of patients who show no early response to intravenous (i.v.) tissue plasminogen activator (tPA) therapy is poor. The objective of this study was to evaluate the feasibility of rescue localized intra-arterial thrombolysis (LIT) therapy for acute ischemic stroke patients after an early non-responsive i.v. tPA therapy. Patients with proximal MCA occlusions who were treated by LIT (n=10) after failure of early response [no improvement or improvement of National Institute of Health Stroke Scale (NIHSS) scores of ≤3] to i.v. tPA therapy (0.9 mg/kg—10% bolus and 90% i.v. infusion over 60 min) were selected. The recanalization rates, incidence of post-thrombolysis hemorrhage and clinical outcomes [baseline and discharge NIHSS scores, mortality, 3 months Barthel index (BI) and modified Rankin score (mRS)] were evaluated. Rescue LIT therapy was performed on ten MCA occlusion patients (male:female=3:7, mean age 71 years). The mean time between the initiation of i.v. tPA therapy and the initiation of intra-arterial urokinase (i.a. UK) was 117±25.0 min [time to i.v. tPA 137±32 min; time to digital subtraction angiography (DSA) 221±42 min; time to i.a. UK 260±46 min]. The baseline NIHSS scores showed significant improvement at discharge (median from 18 to 6). Symptomatic hemorrhage and, consequent, mortality were noted in 2/10 (20%) patients. Three months good outcome was noted in 4/10 (40%, mRS 0–2) and 3/10 (30%, BI ≥95). In conclusion, rescue LIT therapy can be considered as a treatment option for patients not showing early response to full dose i.v. tPA therapy. Larger scale studies for further validation of this protocol may be necessary.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherSpringer-Verlag-
dc.relation.isPartOfNEURORADIOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHBrain Ischemia/complications*-
dc.subject.MESHBrain Ischemia/drug therapy*-
dc.subject.MESHDrug Resistance-
dc.subject.MESHFemale-
dc.subject.MESHFibrinolytic Agents/administration & dosage*-
dc.subject.MESHFibrinolytic Agents/therapeutic use*-
dc.subject.MESHHumans-
dc.subject.MESHInfusions, Intra-Arterial-
dc.subject.MESHInfusions, Intravenous-
dc.subject.MESHIntracranial Hemorrhages-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHStroke/complications*-
dc.subject.MESHStroke/drug therapy*-
dc.subject.MESHThrombolytic Therapy/methods*-
dc.subject.MESHTissue Plasminogen Activator/administration & dosage*-
dc.subject.MESHTissue Plasminogen Activator/therapeutic use*-
dc.subject.MESHTreatment Outcome-
dc.titleRescue localized intra-arterial thrombolysis for hyperacute MCA ischemic stroke patients after early non-responsive intravenous tissue plasminogen activator therapy-
dc.typeArticle-
dc.publisher.locationGermany-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Radiology (영상의학교실)-
dc.contributor.departmentDept. of Radiology (영상의학교실)-
dc.contributor.departmentDept. of Neurology (신경과학교실)-
dc.contributor.departmentDept. of Neurology (신경과학교실)-
dc.contributor.departmentDept. of Neurology (신경과학교실)-
dc.contributor.googleauthorDong Joon Kim-
dc.contributor.googleauthorDong Ik Kim-
dc.contributor.googleauthorSeo Hyun Kim-
dc.contributor.googleauthorKyung Yeol Lee-
dc.contributor.googleauthorJi Hoe Heo-
dc.contributor.googleauthorSang Won Han-
dc.identifier.doi10.1007/s00234-005-1388-2-
dc.contributor.localIdA00408-
dc.contributor.localIdA00410-
dc.contributor.localIdA02648-
dc.contributor.localIdA04284-
dc.contributor.localIdA04369-
dc.relation.journalcodeJ02358-
dc.identifier.eissn1432-1920-
dc.identifier.pmid15983773-
dc.identifier.urlhttp://link.springer.com/article/10.1007%2Fs00234-005-1388-2-
dc.subject.keywordTherapy-
dc.subject.keywordThrombolytic-
dc.subject.keywordStroke-
dc.subject.keywordAcute-
dc.subject.keywordCerebral ischemia-
dc.contributor.alternativeNameKim, Dong Ik-
dc.contributor.alternativeNameKim, Dong Joon-
dc.contributor.alternativeNameLee, Kyung Yul-
dc.contributor.alternativeNameHan, Sang Won-
dc.contributor.alternativeNameHeo, Ji Hoe-
dc.citation.volume47-
dc.citation.number8-
dc.citation.startPage616-
dc.citation.endPage621-
dc.identifier.bibliographicCitationNEURORADIOLOGY, Vol.47(8) : 616-621, 2005-
dc.date.modified2017-05-04-
dc.identifier.rimsid45188-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers

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