ArticleJournal of Korean Neurosurgical Society2023
Recanalization Rate and Clinical Outcomes of Intravenous Tissue Plasminogen Activator Administration for Large Vessel Occlusion Stroke Patients.
Article in Journal of Korean Neurosurgical Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 9 citations in OpenAlex.
- A Systemic embolization model in a rat with real-time micro-fluoroscopy for direct quantification of thrombolysis.MethodsX · 2026Article
- Animal stroke models and outcome evaluation: A review.Animal models and experimental medicine · 2026Review
- Stent retrievers for acute ischemic stroke: technological advances, clinical applications, and future perspectives.Journal of neurology · 2026Review
- Assessing Predictive Factors for Thrombectomy Necessity in Acute Ischemic Stroke: Insights From the Direct to Angio Suite Protocol.Stroke (Hoboken, N.J.) · 2026Article
- Identification of Differential Proteins in Thrombi of Cardioembolic and Atherothrombotic Etiology in Patients with Ischemic Stroke.International journal of molecular sciences · 2025Article
- Endovascular therapy versus medical management in isolated anterior cerebral artery acute ischemic stroke: a multinational multicenter propensity score-weighted study.Journal of neurointerventional surgery · 2025Article
- Comparative effectiveness of intra-arterial thrombolysis vs. mechanical thrombectomy: a literature review.Annals of medicine and surgery (2012) · 2025Review
- A novel anti-ischemic stroke candidate drug AAPB with dual effects of neuroprotection and cerebral blood flow improvement.Acta pharmaceutica Sinica. B · 2025Article
- Transcranial Doppler ultrasound evaluation of vascular recanalization following tissue plasminogen activator intravenous thrombolysis in acute middle cerebral artery occlusion: A case report and literature review.SAGE open medical case reports · 2025Article
- Neuroprotection during Thrombectomy for Acute Ischemic Stroke: A Review of Future Therapies.International journal of molecular sciences · 2024Review
- Dual Mechanical Thrombectomy for Recanalization of a Resistant Acute Posterior Circulation Stroke.Journal of cerebrovascular and endovascular neurosurgery · 2017Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveStroke caused from large vessel occlusion (LVO) has emerged as the most common stroke subtype worldwide. Intravenous tissue plasminogen activator administration (IV-tPA) and additional intraarterial thrombectomy (IA-Tx) is regarded as standard treatment. In this study, the authors try to find the early recanalization rate of IV-tPA in LVO stroke patients.
methodsTotal 300 patients undertook IA-Tx with confirmed anterior circulation LVO, were analyzed retrospectively. Brain computed tomography angiography (CTA) was the initial imaging study and acute stroke magnetic resonance angiography (MRA) followed after finished IV-tPA. Early recanalization rate was evaluated by acute stroke MRA within 2 hours after the IV-tPA. In 167 patients undertook IV-tPA only and 133 non-recanalized patients by IV-tPA, additional IA-Tx tried (IV-tPA + IA-Tx group). And 131 patients, non-recanalized by IV-tPA (IV-tPA group) additional IA-Tx recommend and tried according to the patient condition and compliance.
resultsEarly recanalization rate of LVO after IV-tPA was 12.0% (36/300). In recanalized patients, favorable outcome (modified Rankin Scale, 0-2) was 69.4% (25/36) while it was 32.1% (42/131, p<0.001) in non-recanalized patients. Among 133 patients, nonrecanalized after intravenous recombinant tissue plasminogen activator and undertook additional IA-Tx, the clinical outcome was better than not undertaken additional IA-Tx (favorable outcome was 42.9% vs. 32.1%, p=0.046). Analysis according to the perfusion/diffusion (P/D)-mismatching or not, in patient with IV-tPA with IA-Tx (133 patients), favorable outcome was higher in P/ D-mismatching patient (52/104; 50.0%) than P/D-matching patients (5/29; 17.2%; p=0.001). Which treatment tired, P/D-mismatching was favored in clinical outcome (iv-tPA only, p=0.008 and IV-tPA with IA-Tx, p=0.001).
conclusionThe P/D-mismatching influences on the recanalization and clinical outcomes of IV-tPA and IA-Tx. The authors would like to propose that we had better prepare IA-Tx when LVO is diagnosed on initial diagnostic imaging. Furthermore, if the patient shows P/D-mismatching on MRA after IV-tPA, additional IA-Tx improves treatment results and lessen the futile recanalization.
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