Arterial occlusion sites on magnetic resonance angiography influence the efficacy of intravenous low-dose (0.6 mg/kg) alteplase therapy for ischaemic stroke

International Journal of Stroke : Official Journal of the International Stroke Society
T NakashimaKazuo Minematsu

Abstract

To determine the predictors of efficacy, including magnetic resonance imaging information, for low-dose intravenous alteplase therapy for stroke patients. Seventy-eight patients were prospectively enrolled in a single Stroke Unit (SU) receiving alteplase at a dose of 0.6 mg/kg during the initial 27 months after its approval in Japan. Ischaemic changes and vascular lesions were identified using computed tomography, diffusion-weighted magnetic resonance imaging, and magnetic resonance angiography. Early ischaemic signs were assessed using the Alberta Stroke Program Early CT Score. The median baseline National Institutes of Health Stroke Scale score of 78 patients was 12. In 19 patients (24%), the National Institutes of Health Stroke Scale score improved by >or=8 points at 24 h. After multivariate adjustment, occlusion at the internal carotid artery (odds ratio 11.82, 95% confidence interval 1.73-142.74), Alberta Stroke Program Early CT Score on diffusion-weighted imaging <or=6 (15.23, 1.88-351.50), and a lower National Institutes of Health Stroke Scale score (1.24, 1.08-1.47, per 1-point decrease) were inversely correlated with early improvement. Four patients (5%) had symptomatic intracranial haemorrhage. At 3 months, 76 patient...Continue Reading

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Citations

Oct 10, 2013·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Yuki SakamotoKazunori Toyoda
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Oct 2, 2012·Journal of the Neurological Sciences·Yuki SakamotoKazuo Minematsu
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