Good clinical outcome after ischemic stroke with successful revascularization is time-dependent

• DOI: 10.1212/wnl.0b013e3181b9c847
• Publication Date: 2009-09-28T20:23:49Z
• Authors: P. Khatri; T. Abruzzo; S. D. Yeatts; C. Nichols; J. P. Broderick; T. A. Tomsick
• Keywords: Stroke; Reperfusion Therapy

<b>Background:</b> Trials of IV recombinant tissue plasminogen activator (rt-PA) have demonstrated that longer times from ischemic stroke symptom onset to initiation treatment are associated with progressively lower likelihoods clinical benefit, and likely no benefit beyond 4.5 hours. How the timing rt-PA relates restoration blood flow has been unclear. An understanding relationship between angiographic reperfusion outcome is needed establish time parameters for intraarterial (IA) therapies. <b>Methods:</b> The Interventional Management Stroke pilot trials tested combined IV/IA therapy moderate-to-severe strokes within 3 hours onset. To isolate effect on outcome, we analyzed only middle cerebral artery distal internal carotid occlusions successful (Thrombolysis in Cerebral Infarction 2–3) during interventional procedure (&lt;7 hours). Time was defined as termination. Good modified Rankin Score 0–2 at months. <b>Results:</b> Among 54 cases, age independently predicted good after reperfusion. probability decreased increased (unadjusted <i>p</i> = 0.02, adjusted 0.01) approached cases without 7 <b>Conclusions:</b> We provide evidence following angiographically significantly time-dependent. At later times, may be a poor risk–benefit ratio unselected patients.