Current status of recanalization therapy in acute ischemic stroke with symptomatic intracranial arterial occlusion in Korea

Min Uk Jang, Jeong Ho Hong, Jihoon Kang, Beom Joon Kim, Moon Ku Han, Byung Chul Lee, Kyung Ho Yu, Mi Sun Oh, Keun Sik Hong, Yong Jin Cho, Jong Moo Park, Kyusik Kang, Jae Kwan Cha, Dae Hyun Kim, Tai Hwan Park, Kyung Bok Lee, Soo Joo Lee, Youngchai Ko, Jun Lee, Ki Hyun ChoJoon Tae Kim, Juneyoung Lee, Ji Sung Lee, Hee Joon Bae

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Recent methodological advances in recanalization therapy may alter recanalization strategies and clinical outcomes in patients with symptomatic occlusion of intracranial cerebral arteries. However, few studies have analyzed these changes at a national level, with none conducted in Korea. Methods: On the basis of a prospective multicenter stroke registry database in Korea, 642 consecutive patients hospitalized within 12 hours of the onset with symptomatic occlusion of intracranial major cerebral arteries between March 2010 and November 2011 were identified. Recanalization therapy was used in 48% (n = 307) of patients; intravenous thrombolysis only (IVT) in 46%, intra-arterial thrombolysis only (IAT) in 16%, and combined thrombolysis (CMT) in 38%. Of the 166 patients treated by IAT or CMT, the Penumbra system or the Solitaire was used in 58% of patients. Results: Early neurologic improvement (ENI), 3-month modified Rankin scale (mRS) score of 2 or less, and symptomatic hemorrhagic transformation (SHT) were observed in 43%, 39%, and 9% of the patients in the IVT group; 52%, 27%, and 12% of the patients in the IAT group; and 54%, 39%, and 12% of the patients in the CMT group, respectively. Compared with no treatment, adjusted odd ratios (95% confidence intervals) of recanalization therapy were 1.59 (1.04-2.42) for ENI, 1.37 (.81-2.30) for 3-month mRS score of 2 or less, and 2.58 (1.12-5.91) for SHT. Conclusions: The variety and active use of endovascular approaches were quite noticeable. As a whole, recanalization therapy tended to contribute to favorable outcomes despite a significant increase of symptomatic hemorrhage.

Original languageEnglish
Pages (from-to)e339-e346
JournalJournal of Stroke and Cerebrovascular Diseases
Volume23
Issue number5
DOIs
Publication statusPublished - 2014

Keywords

  • Korea
  • Recanalization therapy
  • acute ischemic stroke
  • endovascular treatment
  • intracranial arterial occlusion
  • outcome
  • registry
  • thrombolysis

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Jang, M. U., Hong, J. H., Kang, J., Kim, B. J., Han, M. K., Lee, B. C., Yu, K. H., Oh, M. S., Hong, K. S., Cho, Y. J., Park, J. M., Kang, K., Cha, J. K., Kim, D. H., Park, T. H., Lee, K. B., Lee, S. J., Ko, Y., Lee, J., ... Bae, H. J. (2014). Current status of recanalization therapy in acute ischemic stroke with symptomatic intracranial arterial occlusion in Korea. Journal of Stroke and Cerebrovascular Diseases, 23(5), e339-e346. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.12.027