Abstract:
BACKGROUND AND PURPOSE:We hypothesize that in acute middle cerebral artery stroke, thrombus lengths measured in thin-slice nonenhanced CT images define a limit beyond which systemic thrombolysis will fail to recanalize occluded arteries. METHODS:In 138 patients who presented with acute middle cerebral artery stroke and who were treated with intravenous thrombolysis (IVT), we measured lengths of thrombotic clots depicted as arterial hyperdensities in admission nonenhanced CT images with 2.5-mm slice width. Vascular recanalization was investigated after thrombolysis and recanalization results were related to thrombus lengths by logistic regression. RESULTS:In 62 patients, IVT resulted in recanalization; among these patients, no thrombus length exceeded 8 mm. The median modified Rankin scale score at hospital discharge was 2. In the remaining 76 patients, thrombus lengths mostly exceeded 8 mm and IVT failed in recanalization. These patients were discharged with a median modified Rankin scale score of 5. CONCLUSIONS:This study shows that in acute middle cerebral artery stroke, IVT has nearly no potential to recanalize occluded vessels if thrombus length exceeds 8 mm.
journal_name
Strokejournal_title
Strokeauthors
Riedel CH,Zimmermann P,Jensen-Kondering U,Stingele R,Deuschl G,Jansen Odoi
10.1161/STROKEAHA.110.609693subject
Has Abstractpub_date
2011-06-01 00:00:00pages
1775-7issue
6eissn
0039-2499issn
1524-4628pii
STROKEAHA.110.609693journal_volume
42pub_type
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