In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
Abstract:
Introduction: Occlusions of the M2 branch show recanalization rates of 44% at 2 hours post treatment with IV-tPA when measured by TCD however no studies have looked at recanalization rates in early ( 〈 6h) time windows with angiography. Objectives: We aim to define recanalization rates for M2 occlusions with IV-tPA in an early time window ( 〈 6H) using CTA and explore the role of M2 size and clot length in predicting successful recanalization. Methods: patients with acute intracranial occlusions were prospectively enrolled into the InterrSect study and had a baseline CTA at time of inclusion and within 6 hours of receiving IV-tPA. Baseline CTA was analyzed on the OSIRIX platform; two experienced raters measured M2 diameter at the proximal clot interface and M1 diameter at mid-segment on axial MIP images. Two experienced raters independently analyzed clot length and recanalization on follow-up CTA (75/81) and first run angiograms (6/81). Clot length was stratified as (long 〉 15mm) or (short0.8) or (Low 〈 = 0.8). Results: 81 patients with M2 occlusions treated with IV-tPA were included in the study. Successful recanalization was achieved in 63.5% of patients with IV-tPA within 4-6 hours of bolus. Figure1 demonstrates a significant relationship between clot lengths, ratio M2/M1 to early recanalization (Fishers exact p= 0.035). Using general linear modelling, the rate of early recanalization is 1.9 times (p= 0.018, 95%CI 1.12-3.37) higher in the Short clot-Low M2/M1 ratio group when compared to the group with long clot and high ratio after adjusting for age. Conclusion: Small M2 clots treated with IV-tPA achieve early recanalization exceeding 80%; large M2 clots in comparison achieve recanalization rates below 50%. The later clots could be included in clinical trials comparing IV with endovascular therapy.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/str.45.suppl_1.tmp23
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2014
detail.hit.zdb_id:
1467823-8
