Intra-arterial vasodilator use during endovascular therapy for acute ischemic stroke might improve reperfusion rate

Ann N Y Acad Sci. 2012 Sep:1268:134-40. doi: 10.1111/j.1749-6632.2012.06753.x.

Abstract

Treatment of acute ischemic stroke (AIS) is an evolving field. New treatment options are still needed in order to achieve greater success rates for arterial recanalization. Intra-arterial therapy (lAT) is an option for AIS patients who are not good candidates for intravenous (i.v.) recombinant tissue plasminogen activator (rt-PA) or where it has failed. While good data establishing the role of IAT in AIS management are lacking, the potential clinical efficacy of IAT is based on the premise that recanalization and reperfusion may result in better clinical outcome. Although lAT recanalization and reperfusion rates of large vessel occlusion are much higher than they are for i.v. rt-PA, IAT's radiological efficacy is still far from perfect. Vasodilator use during IAT for AIS may increase the recanalization and reperfusion rates of such therapy. In this report, we describe the radiographic and clinical outcomes in a cohort of AIS patients who received intra-arterial (i.a.) vasodilators during IAT and summarize the role of i.a. vasodilators in the process of recanalization and reperfusion.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / drug therapy*
  • Brain Ischemia / surgery
  • Calcium Channel Blockers / administration & dosage
  • Calcium Channel Blockers / therapeutic use*
  • Cerebrovascular Circulation
  • Combined Modality Therapy
  • Endovascular Procedures
  • Female
  • Humans
  • Infusions, Intra-Arterial
  • Male
  • Middle Aged
  • Nitroglycerin / administration & dosage
  • Nitroglycerin / therapeutic use*
  • Radiography
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / therapeutic use
  • Reperfusion
  • Retrospective Studies
  • Thrombectomy
  • Tissue Plasminogen Activator / administration & dosage*
  • Tissue Plasminogen Activator / therapeutic use
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage
  • Vasodilator Agents / therapeutic use*
  • Verapamil / administration & dosage
  • Verapamil / therapeutic use*
  • Young Adult

Substances

  • Calcium Channel Blockers
  • Recombinant Proteins
  • Vasodilator Agents
  • Verapamil
  • Tissue Plasminogen Activator
  • Nitroglycerin