Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal HematomasReportar como inadecuado




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Radiology Research and Practice - Volume 2015 2015, Article ID 159815, 5 pages -

Clinical Study

Institute of Radiology and Neuroradiology, Asklepios Hospital Barmbek, Hamburg, Germany

Department of Neurology, Asklepios Hospital St. Georg, Hamburg, Germany

Department of Neurology, Asklepios Hospital Barmbek, Hamburg, Germany

Received 14 July 2015; Accepted 21 October 2015

Academic Editor: Henrique M. Lederman

Copyright © 2015 J. Höltje et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. In acute stroke by occlusion of the proximal medial cerebral artery MCA or the distal internal carotid artery, intravenous thrombolysis is an established treatment. Another option is mechanical recanalization. It remains unclear if the combination of both methods poses an additional bleeding risk. The aim of this retrospective analysis is to determine the proportion of hemorrhagic infarctions and parenchymal hematomas. Methods. Inclusion criteria were an occlusion of the carotid T or proximal MCA treated with full dose thrombolysis and mechanical recanalization. 31 patients were selected. Devices used were Trevo, Penumbra Aspiration system, Penumbra 3D Retriever, and Revive. The initial control by computed tomography was carried out with a mean delay to intervention of 10.9 hours SD: 8.5 hours. Results. A slight hemorrhagic infarction HI1 was observed in 2-31 patients, and a more severe HI2 occurred in two cases. A smaller parenchymal hematoma PH1 was not seen and a space-occupying PH2 was seen in 2-31 cases. There was no significant difference in the probability of intracranial bleeding after successful thrombolysis in cerebral infarctions 2b and 3 or unsuccessful recanalization. Conclusion. The proportion of intracranial bleeding using mechanical recanalization following intravenous thrombolysis appears comparable with reports using thrombolysis alone.





Autor: J. Höltje, F. Bonk, A. Anstadt, C. Terborg, C. Pohlmann, P. P. Urban, and R. Brüning

Fuente: https://www.hindawi.com/



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