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Comparison of stent retriever and intra- arterial fibrinolysis in patients with acute ischaemic stroke

Authors
 D. Song  ;  B. M. Kim  ;  D. J. Kim  ;  Y. D. Kim  ;  J. Kim  ;  H. S. Lee  ;  H. S. Nam  ;  J. H. Heo 
Citation
 EUROPEAN JOURNAL OF NEUROLOGY, Vol.21(5) : 779-784, 2014 
Journal Title
 EUROPEAN JOURNAL OF NEUROLOGY 
ISSN
 1351-5101 
Issue Date
2014
MeSH
Aged ; Aged, 80 and over ; Brain Ischemia/complications ; Female ; Fibrinolysis ; Humans ; Male ; Middle Aged ; Reperfusion ; Retrospective Studies ; Statistics, Nonparametric ; Stents* ; Stroke/etiology ; Stroke/therapy* ; Thrombectomy/methods ; Thrombolytic Therapy/methods* ; Tomography Scanners, X-Ray Computed ; Treatment Outcome
Keywords
ischaemic stroke ; reperfusion ; thrombectomy ; thrombolysis
Abstract
BACKGROUND AND PURPOSE: Although the stent retriever (SR) has shown a better reperfusion rate and clinical outcome than the older generation mechanical clot retrieval device, it is uncertain whether the SR is superior to intra-arterial fibrinolysis (IAF). METHODS: Ischaemic stroke patients who were treated with SR or IAF as initial endovascular treatment modality for unilateral arterial occlusion in the anterior circulation were included. Successful reperfusion was defined as Thrombolysis in Cerebral Infarction grade ≥2b. A favourable clinical outcome was defined as a modified Rankin Score ≤2 at 3 months. RESULTS: Between January 2009 and May 2012, 55 patients were treated with SR and 50 patients were treated with IAF. The baseline characteristics were similar between the two groups except for the occlusion site and rescue treatment. In binary logistic regression analysis adjusted for the occlusion site and rescue treatment, SR was independently associated with increased successful reperfusion [82.0% vs. 47.3%; odds ratio (OR) 5.21; 95% confidence interval (CI) 1.92-14.14) and a more favourable clinical outcome at 3 months (54.0% vs. 43.6%; OR 3.40; 95% CI 1.31-8.84). The frequency of symptomatic intracranial haemorrhage and mortality at 3 months was not different between the two groups. CONCLUSIONS: Stent retriever was as safe as and more effective than IAF. Our findings suggest that SR may be considered as an initial modality rather than IAF in acute stroke patients who undergo endovascular treatment.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/ene.12391/abstract
DOI
10.1111/ene.12391
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Jinkwon(김진권) ORCID logo https://orcid.org/0000-0003-0156-9736
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Song, Dong Beom(송동범)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98674
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