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首页> 外文期刊>Journal of neurology >Outcome of MRI-based intravenous thrombolysis in carotid-T occlusion
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Outcome of MRI-based intravenous thrombolysis in carotid-T occlusion

机译：基于MRI的颈动脉T型闭塞静脉溶栓治疗的结果

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Low recanalization rates and poor clinical outcome have been reported after intravenous thrombolysis (IV-tPA) in carotid-T occlusion (CTO). We studied clinical outcome and imaging findings of MRI-based intravenous thrombolysis in CTO. Data of patients with acute ischemic stroke and CTO treated with IV-tPA within 6 h of symptom onset based on MRI criteria were retrospectively analyzed. Vessel occlusion was defined based on MR angiography. Acute diffusion and perfusion lesion volumes and final infarct volumes after 3-7 days were delineated. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the neurological deficit on admission. Recanalization was evaluated after 24 h. Clinical outcome was assessed using the modified Rankin Scale (mRS) after 90 days. Clinical and imaging data were compared to patients with middle cerebral artery main stem occlusion (MCAO). A total of 20 patients with CTO and 51 patients with MCAO were studied. Onset to treatment time, NIHSS on admission, initial diffusion and perfusion lesion volumes, and recanalization rates after 24 h were similar between groups. Final infarct volume was larger for CTO (82 vs. 30 ml, p = 0.006). Although overall outcome was not significantly different between groups (p = 0.251), independent outcome (mRS 0-2) tended to be less frequent in CTO (17 vs. 39 %), while poor outcome (mRS 4-6) appeared more common (72 vs. 43 %). The proportion of patients with good clinical outcome after intravenous thrombolysis in CTO is small. Moreover, final infarct volume is larger and clinical outcome appears to be worse compared to MCAO.
机译：据报道在颈动脉T型闭塞（CTO）中进行静脉溶栓（IV-tPA）后，再通率较低且临床结果较差。我们研究了CTO中基于MRI的静脉溶栓治疗的临床结局和影像学发现。回顾性分析根据MRI标准在症状发作6小时内用IV-tPA治疗的急性缺血性卒中和CTO患者的数据。血管闭塞是根据MR血管造影确定的。描绘了3-7天后的急性扩散和灌注病变体积和最终梗塞体积。美国国立卫生研究院卒中量表（NIHSS）用于评估入院时的神经功能缺损。 24小时后评估再通。 90天后使用改良的Rankin量表（mRS）评估临床结局。将临床和影像数据与脑中动脉主干闭塞（MCAO）患者进行比较。共研究了20例CTO患者和51例MCAO患者。各组在治疗时间，入院时NIHSS，初始扩散和灌注病变量以及24 h后再通率方面相似。 CTO的最终梗塞体积更大（82 vs. 30 ml，p = 0.006）。尽管各组的总体预后没有显着差异（p = 0.251），但CTO中独立预后（mRS 0-2）的发生率较低（17 vs. 39％），而不良预后（mRS 4-6）似乎更为常见。 （72比43％）。 CTO静脉溶栓后临床预后良好的患者比例很小。而且，与MCAO相比，最终的梗塞体积更大，临床结局似乎更差。

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