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- Title
Angioplasty and stenting as an adjunct to Intraarterial thrombolysis in patients with acute ischemic stroke of carotid circulation.
- Authors
Vijaya, P.; Raghava, Sarma P. V.; Sunitha, M.
- Abstract
Introduction: Intraarterial thrombolysis (IAT) has been reported to be effective in large vessel blocks. However in some, IAT alone may not be adequate. Balloon angioplasty / stenting can be an useful adjunct to improve recanalization, prevent reocclusion & to permit distal infusion of thrombolytic agents in tandem occlusions. Aim: To study the feasibility, safety & efficacy of emergency Angioplasty/stenting in Acute carotid strokes. Methods: 21 consecutive patients of Acute carotid territory strokes were treated with mechanical intervention. All patients received urokinaee first, of these 15 patients were treated with PTBA & 7 patients recieved stent in addition. In 5 pts the stenting was done acutely following thrombolysis. In 2 pts delayed intervention done within 7 days of onset. The Successful recanalisation taken as TIMI grades 2 & 3. Good outcome taken as Rankin scale 0-3. Results: There were 15 men and 6 women. Age ranged 21 to 80 yrs (median-53). NIH scale 10-24 (meadian-17), window period 2.5-8 hrs (meadian -4.5 hrs). The site of block, extra cranial ICA-8, Intra cranial-2, combined - 6, ICA+MCA block in 3, MCA alone 2. The Urokinase dose ranged from 1-8 lakhs. All pts tolerated the procedure well. Successful recanalisation was obtained in 16 pts (76%), 3 pts (14.2%)died. No pt had hemorrhage. Overall 10 (47.6%) pts had Excellent outcome, 5 (23.8%) pts had fair outcome and 6 (28.5%) patients had poor outcome. Extra cranial ICA blocks had better outcomes. Conclusions: Balloon angioplasty is feasible, safe, effective, adjuvant therapy in patients with acute carotid territory occlusions improving recanalisation rates & outcomes
- Subjects
ANGIOPLASTY; SURGICAL stents; THROMBOLYTIC therapy; CEREBRAL ischemia; CAROTID body
- Publication
Annals of Indian Academy of Neurology, 2007, Vol 10, p52
- ISSN
0972-2327
- Publication type
Abstract