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Titolo:
rtPA intravenous thrombolysis in anterior choroidal artery territory stroke
Autore:
Trouillas, P; Derex, L; Nighoghossian, N; Honnorat, J; Li, W; Neuschwander, P; Riche, G; Getenet, JC; Berthezene, Y; Turjman, F; Froment, JC;
Indirizzi:
Hop Neurol, Unite Cerebrovasc, F-69003 Lyon, France Hop Neurol Lyon France F-69003 , Unite Cerebrovasc, F-69003 Lyon, France Hop Neurol, Ataxia Res Ctr, F-69003 Lyon, France Hop Neurol Lyon France F-69003 rol, Ataxia Res Ctr, F-69003 Lyon, France Hop Neurol, Dept Neuroradiol, F-69003 Lyon, France Hop Neurol Lyon France F-69003 l, Dept Neuroradiol, F-69003 Lyon, France
Titolo Testata:
NEUROLOGY
fascicolo: 3, volume: 54, anno: 2000,
pagine: 666 - 673
SICI:
0028-3878(20000208)54:3<666:RITIAC>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
TISSUE-PLASMINOGEN-ACTIVATOR; MIDDLE CEREBRAL-ARTERY; ACUTE ISCHEMIC STROKE; CAROTID TERRITORY; CLINICAL SYNDROMES; URGENT THERAPY; EMBOLIC STROKE; INFARCTS; TRIAL; PATHOGENESIS;
Keywords:
recombinant tissue plasminogen activator; intravenous; choroidal artery; reinfarct;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
42
Recensione:
Indirizzi per estratti:
Indirizzo: Trouillas, P Hop Neurol, Unite Cerebrovasc, 59 Blvd Pinel, F-69003 Lyon, France Hop Neurol 59 Blvd Pinel Lyon France F-69003 03 Lyon, France
Citazione:
P. Trouillas et al., "rtPA intravenous thrombolysis in anterior choroidal artery territory stroke", NEUROLOGY, 54(3), 2000, pp. 666-673

Abstract

Objective: To study the possible specific response to recombinant tissue plasminogen activator (rtPA) thrombolysis of anterior choroidal artery (AChA) stroke. Background: Outcome and response after rtPA thrombolysis are possibly better in small-vessel infarcts, but a specific study of AChA stroke has not yet been performed. Methods: The authors proposed an open trial of TV rtPA within 7 hours in patients age 20 and 81 years with all types of internal carotid artery territory stroke if the baseline Scandinavian Stroke Scale (SSS) score was less than 48. A dose of rtPA 0.8 mg/kg was infused over 90 minutes, Of 114 consecutive patients, 9 patients (7.9%) exhibited hypodensity in the AChA territory on day 1 brain CT. Results: Seven of nine patients with AChA infarct had a primary early recovery within 6 hours after the initiation of rtPA infusion, In addition, recovery was complete in five patients and partial in two patients. No intracerebral hematoma was observed, Three patients had a "reinfarct syndrome" at 12, 25, and 48 hours respectively. However, in the two latter patients treated with IV heparin, the deficit disappeared again with the increase of heparin dose in one patient and disappeared spontaneously in the other patient. The overall outcome at day 90 was six total recoveries in nine patients (66%). Patients with a finalgood outcome had a slight "unstructured" hypodensity in the AChA territoryon day 1 brain CT, whereas patients with a bad outcome had the classic "structured" hypodensity of AChA territory stroke. Conclusion: These data support a specific quick response of AChA territory stroke to IV rtPA thrombolysis, probably due to the small size of the artery and of the "clot. " The high frequency of the reinfarct syndrome is a clinical fact that is difficultto explain. Efficient heparin treatment after 24 hours may control the reinfarct syndrome in some patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/11/20 alle ore 14:43:21