Intravenous thrombolysis in patients with stroke attributable to small artery occlusion.

Détails

ID Serval
serval:BIB_8370DE49C107
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Intravenous thrombolysis in patients with stroke attributable to small artery occlusion.
Périodique
European Journal of Neurology
Auteur(s)
Fluri F., Hatz F., Rutgers M.P., Georgiadis D., Sekoranja L., Schwegler G., Sarikaya H., Weder B., Müller F., Lüthy R., Arnold M., Reichhart M., Mattle H.P., Tettenborn B., Nedeltchev K., Hungerbühler H.J., Sztajzel R., Baumgartner R.W., Michel P., Lyrer P.A., Engelter S.T.
ISSN
1468-1331[electronic]
ISSN-L
1351-5101 [linking]
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
17
Numéro
8
Pages
1054-1060
Langue
anglais
Résumé
BACKGROUND: Intravenous thrombolysis (IVT) for stroke seems to be beneficial independent of the underlying etiology. Recent observations raised concern that IVT might cause harm in patients with strokes attributable to small artery occlusion (SAO).
OBJECTIVE: The safety of IVT in SAO-patients is addressed in this study.
METHODS: We used the Swiss IVT databank to compare outcome and complications of IVT-treated SAO-patients with IVT-treated patients with other etiologies (non-SAO-patients). Main outcome and complication measures were independence (modified Rankin scale <or=2) at 3 months, intracranial hemorrhage (ICH), and recurrent ischaemic stroke.
RESULTS: Sixty-five (6.2%) of 1048 IVT-treated patients had SAO. Amongst SAO-patients, 1.5% (1/65) patients died, compared to 11.2% (110/983) in the non-SAO-group (P = 0.014). SAO-patients reached independence more often than non-SAO-patients (75.4% versus 58.9%; OR 2.14 (95% CI 1.20-3.81; P = 0.001). This association became insignificant after adjustment for age, gender, and stroke severity (OR 1.41 95% CI 0.713-2.788; P = 0.32). Glucose level and (to some degree) stroke severity but not age predicted 3-month-independence in IVT-treated SAO-patients. ICHs (all/symptomatic) were similar in SAO- (12.3%/4.6%) and non-SAO-patients (13.4%/5.3%; P > 0.8). Fatal ICH occurred in 3.3% of the non-SAO-patients but none amongst SAO-patients. Ischaemic stroke within 3 months after IVT reoccurred in 1.5% of SAO-patients and in 2.3% of non-SAO-patients (P = 0.68).
CONCLUSION: IVT-treated SAO-patients died less often and reached independence more often than IVT-treated non-SAO-patients. However, the variable 'SAO' was a dependent rather than an independent outcome predictor. The absence of an excess in ICH indicates that IVT seems not to be harmful in SAO-patients.
Mots-clé
complications, etiology, outcome, small artery occlusion, stroke, thrombolysis, acute ischemic-stroke, tissue-plasminogen activator, rt-pa stroke, intracerebral hemorrhage, clinical-trial, subtype, population, classification, leukoaraiosis, association
Pubmed
Web of science
Création de la notice
17/08/2010 14:48
Dernière modification de la notice
03/03/2018 18:52
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