caa a22 4500 606214844 CHVBK 20210128101056.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00701-014-2341-0 doi (NATIONALLICENCE)springer-10.1007/s00701-014-2341-0 Clinical results of intraarterial thrombolysis according to tPA administration and perfusion/diffusion mismatching [Elektronische Daten] [Yoo-Dong Won, Tae-Kyu Lee, Young-Joo Kim, Chang-Woo Chun, Do-Sung Yoo, Shin-Soo Jun] Background: IA-Tx and advanced dynamic imaging studies have been adopted for ischemic stroke patient treatment. Many patients are treated with IV-tPA, but this treatment is not always feasible. In this study, IA-Tx was used for patients for whom IV-tPA was not indicated or when IV-tPA did not result in recanalization. Methods: A total of 156 patients treated with IA-Tx were retrospectively reviewed. Of these, 72 patients were treated with a full dose of IV-tPA before receiving the IA-Tx; the remaining 84 patients only received IA-Tx. An initial imaging study using CTA and acute stroke MRI followed. Patients' demographics and clinical results were recorded and compared according to P/D mismatching and IV-tPA. Results: Among P/D-mismatched patients, the recanalization rate was 80% and the symptomatic intracranial hemorrhage rate was 14.5%, while among P/D-matched patients, the rates were 63% and 41.3% respectively (p < 0.05). A favorable clinical outcome occurred in 49.1% of P/D-mismatched, but only in 21.7% of P/D-matched patients (p < 0.05). Among patients who were treated with IV-tPA before undergoing IA-Tx, the recanalization rate was 79.2% and the sICH rate was 27.8%, while it was 71.4% and 17.9% in patients who did not receive IV-tPA (p < 0.05). Conclusions: Patients who have P/D mismatching and are treated with IA-Tx have higher recanalization rates and a greater probability of a favorable outcome than patients who have P/D matching and receive IA-Tx. For patients who do not undergo successful recanalization after IV-tPA or who are not indicated for IV-tPA, the authors recommend IA-Tx after undergoing appropriate imaging evaluation. Springer-Verlag Wien, 2015 Intraarterial thrombolysis nationallicence Tissue plasminogen activator nationallicence Perfusion/diffusion mismatching nationallicence Neurologic outcome nationallicence Hemorrhagic complication nationallicence Won Yoo-Dong Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea aut Lee Tae-Kyu Department of Neurosurgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 65-1, Kumoh-dong, 480-130, Uijeongbu-City, Gyeonggi-do, Korea aut Kim Young-Joo Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea aut Chun Chang-Woo Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea aut Yoo Do-Sung Department of Neurosurgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 65-1, Kumoh-dong, 480-130, Uijeongbu-City, Gyeonggi-do, Korea aut Jun Shin-Soo Department of Neurosurgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 65-1, Kumoh-dong, 480-130, Uijeongbu-City, Gyeonggi-do, Korea aut Acta Neurochirurgica Springer Vienna 157/3(2015-03-01), 389-398 0001-6268 157:3<389 2015 157 701 https://doi.org/10.1007/s00701-014-2341-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-014-2341-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Won Yoo-Dong Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea aut NATIONALLICENCE 700 1- Lee Tae-Kyu Department of Neurosurgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 65-1, Kumoh-dong, 480-130, Uijeongbu-City, Gyeonggi-do, Korea aut NATIONALLICENCE 700 1- Kim Young-Joo Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea aut NATIONALLICENCE 700 1- Chun Chang-Woo Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea aut NATIONALLICENCE 700 1- Yoo Do-Sung Department of Neurosurgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 65-1, Kumoh-dong, 480-130, Uijeongbu-City, Gyeonggi-do, Korea aut NATIONALLICENCE 700 1- Jun Shin-Soo Department of Neurosurgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 65-1, Kumoh-dong, 480-130, Uijeongbu-City, Gyeonggi-do, Korea aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/3(2015-03-01), 389-398 0001-6268 157:3<389 2015 157 701