Long-term effect of intra-arterial thrombolysis in stroke.
- Nedeltchev K Department of Neurology, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern, Switzerland.
- Fischer U
- Arnold M
- Ballinari P
- Haefeli T
- Kappeler L
- Brekenfeld C
- Remonda L
- Schroth G
- Mattle HP
- 2006-10-28
Published in:
- Stroke. - 2006
Aged
Databases, Factual
Female
Follow-Up Studies
Humans
Injections, Intra-Arterial
Male
Middle Aged
Registries
Stroke
Thrombolytic Therapy
Time Factors
English
BACKGROUND AND PURPOSE
Thrombolysis has been shown to improve the 3-month outcome of patients with ischemic stroke, but knowledge of the long-term effect of thrombolysis is limited.
METHODS
The present study compares the long-term outcome of stroke patients who were treated with intra-arterial thrombolysis (IAT) using urokinase with the outcome of patients treated with aspirin. The modified Rankin Scale (mRS) was used to assess the outcome; 173 patients treated with IAT and 261 patients treated with aspirin from the Bernese Stroke Data Bank were eligible for the study. A matching algorithm taking into account patient age and stroke severity on admission (as measured by the National Institute of Health Stroke Scale [NIHSS]) was used to assemble an IAT and an aspirin group.
RESULTS
One hundred and forty-four patients treated with IAT and 147 patients treated with aspirin could be matched and included in the comparative analysis. The median NIHSS score was 14 in each group. At 2 years, 56% of the patients treated with IAT and 42% of the patients treated with aspirin achieved functional independence (mRS, 0 to 2; P=0.037). Clinical outcome was excellent (mRS, 0 to 1) in 40% of the IAT and in 24% of the aspirin patients (P=0.008). Mortality was 23% and 24%, respectively.
CONCLUSIONS
The present study provides evidence for a sustained effect of IAT when assessed 2 years after the stroke.
Thrombolysis has been shown to improve the 3-month outcome of patients with ischemic stroke, but knowledge of the long-term effect of thrombolysis is limited.
METHODS
The present study compares the long-term outcome of stroke patients who were treated with intra-arterial thrombolysis (IAT) using urokinase with the outcome of patients treated with aspirin. The modified Rankin Scale (mRS) was used to assess the outcome; 173 patients treated with IAT and 261 patients treated with aspirin from the Bernese Stroke Data Bank were eligible for the study. A matching algorithm taking into account patient age and stroke severity on admission (as measured by the National Institute of Health Stroke Scale [NIHSS]) was used to assemble an IAT and an aspirin group.
RESULTS
One hundred and forty-four patients treated with IAT and 147 patients treated with aspirin could be matched and included in the comparative analysis. The median NIHSS score was 14 in each group. At 2 years, 56% of the patients treated with IAT and 42% of the patients treated with aspirin achieved functional independence (mRS, 0 to 2; P=0.037). Clinical outcome was excellent (mRS, 0 to 1) in 40% of the IAT and in 24% of the aspirin patients (P=0.008). Mortality was 23% and 24%, respectively.
CONCLUSIONS
The present study provides evidence for a sustained effect of IAT when assessed 2 years after the stroke.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1161/01.STR.0000249417.24085.80
- PMID 17068302
- Persistent URL
- https://sonar.ch/global/documents/6747
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