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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
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. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
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
김동준(Kim, Dong Joon) ORCID logo https://orcid.org/0000-0002-7035-087X
김병문(Kim, Byung Moon) ORCID logo https://orcid.org/0000-0001-8593-6841
김영대(Kim, Young Dae)
김진권(Kim, Jinkwon) ORCID logo https://orcid.org/0000-0003-0156-9736
남효석(Nam, Hyo Suk) ORCID logo https://orcid.org/0000-0002-4415-3995
송동범(Song, Dong Beom)
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
허지회(Heo, Ji Hoe) ORCID logo https://orcid.org/0000-0001-9898-3321
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98674
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