Predictors for recanalization after intravenous thrombolysis in acute ischemic stroke

J Stroke Cerebrovasc Dis. Jan-Feb 2007;16(1):21-4. doi: 10.1016/j.jstrokecerebrovasdis.2006.08.002.

Abstract

Objective: The purpose of this study was to evaluate clinical aspects of recanalization and to assess variables associated with early recanalization.

Methods: In all, 27 consecutive patients treated with intravenous thrombolysis were examined with the National Institutes of Health Stroke Scale (NIHSS) and transcranial Doppler ultrasound at presentation and at 2 and 24 hours after treatment.

Results: Recanalization less than 24 hours after treatment was found in 70% of patients. Patients who recanalized had lower NIHSS score on presentation (P = .01) and significant improvement in NIHSS score at 0 to 2 hours (P = .042) and 0 to 24 hours (P = .002) compared with those who did not recanalize. Atrial fibrillation (P = .04), higher serum glucose values on presentation (P = .05), and more traditional risk factors (P = .05) were associated with no recanalization.

Conclusions: Recanalization is associated with clinical improvement. High NIHSS score, atrial fibrillation, high serum glucose, and higher number of risk factors indicate a reduced probability for recanalization.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / epidemiology
  • Blood Glucose / analysis
  • Comorbidity
  • Coronary Disease / epidemiology
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / epidemiology
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Hypercholesterolemia / epidemiology
  • Hypertension / epidemiology
  • Infarction, Middle Cerebral Artery / blood
  • Infarction, Middle Cerebral Artery / diagnostic imaging
  • Infarction, Middle Cerebral Artery / drug therapy*
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Prognosis
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / pharmacology
  • Recombinant Proteins / therapeutic use
  • Risk Factors
  • Severity of Illness Index
  • Smoking / epidemiology
  • Thrombolytic Therapy*
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / pharmacology
  • Tissue Plasminogen Activator / therapeutic use
  • Treatment Outcome
  • Ultrasonography, Doppler, Transcranial
  • Vascular Patency* / drug effects

Substances

  • Blood Glucose
  • Fibrinolytic Agents
  • Recombinant Proteins
  • Tissue Plasminogen Activator