Introduction Endovascular therapy using IA tPA +/- Thrombectomy is an option for those who are either not a candidate or failed IV tPA. However, a little is known about age specific outcome. Our objectives are to describe the radiographic and clinical outcome of young patients (<65) who underwent acute stroke interventional therapy as well as evaluate the role of IA vasodilators in the process of recanalization.
Methods Consecutive patients underwent acute stroke intervention from 2007 to 2010 were enrolled. Patients demographic, presenting NIHSS, use of IA thrombolytic, vasodilator, and recanalization rate were recorded. Patients' outcome using Glasgow Outcome Scale Score was measured at 30 days.
Results 38 patients (mean age 38±14; median NIHSS 16) received intervention, 11 patients had failed IV tPA. Patients were offered therapy within 8 h except for five cases (stroke at awakening). IA tPA was given in 36, thrombectomy was done in 30, and 21 patients received IA vasodilator (16 Varapamil; 5 Nitroglycerine). Overall recanalization was near to complete in 92%. All patients received IA vasodilator have recanilized (TIMI III 13/21 and TIMI II 8/21).
Overall 30-days outcome Good was observed in 51% (GOS 5 in 11, GOS 4 in 7), Dependence (GOS 3) in 34%, and Death (GOS 1) in 14%; vasodilators' group showed similar outcome with Good in 42% (7/17), Dependence in 41% (7/17) and Death in 17% (3/17). Poor outcome was associated with high NIHSS and poor recanalization.
Conclusions Acute endovascular therapy achieves a high rate of recanalization in young acute ischemic stroke. IA vasodilators use during thrombectomy was associated with higher rate of recanalization. Further study is required to evaluate the role of vasodilators in acute stroke interventions.
Competing interests None.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.