Aggressive Mechanical Clot Disruption

• DOI: 10.1161/01.str.0000152331.93770.18
• Publication Date: 2004-12-30T03:39:57Z
• Authors: Elizabeth A. Noser; Hashem M. Shaltoni; Christiana E. Hall; Andrei V. Alexandrov; Zsolt Garami; Edwin D. Cacayorin; Joon K. Song; James C. Grotta; Morgan S. Campbell
• Keywords: Stroke; Fibrinolytic agent

Background and Purpose— This study evaluated the safety efficacy of aggressive mechanical clot disruption (AMCD) in acute stroke patients with persisting middle cerebral artery (MCA) or internal carotid (ICA) occlusion after thrombolytic therapy. Methods— Retrospective case series were used from a prospectively collected database on consecutive ischemic treated intra-arterial (IA) thrombolytics during 5-year interval. Thrombolytic dosage, endovascular techniques, immediate final recanalization rates, symptomatic hemorrhage, mortality, outcome determined. Results— Thirty-two received AMCD. Median baseline National Institutes Health Stroke Scale (NIHSS) score was 18, median time to initiation IA treatment 261 minutes symptom onset. ICA noted 16 MCA patients: 22 combined IV/IA thrombolytics, 3 IV 6 1 patient no before No periprocedural complications noted. Immediate achieved 38% (50% MCA, 25% ICA) 75% (88% 63% patients. Favorable occurred 19 (59%) patients, hemorrhage (9.4%) mortality 4 (12.5%) Conclusion— AMCD can be performed safely comparable intracerebral rates other therapies even use intravenous selected Early deployment this technique leads one third may potentially shorten flow restoration improve overall