PT  - JOURNAL ARTICLE
AU  - Sang Hun Lee
AU  - Dae Chul Suh
AU  - Su Hee Cho
AU  - Jae Jon Sheen
AU  - Deok Hee Lee
AU  - Jong S Kim
TI  - Subacute endovascular recanalization of symptomatic cerebral artery occlusion: a propensity score-matched analysis
AID  - 10.1136/neurintsurg-2017-013219
DP  - 2017 Sep 12
TA  - Journal of NeuroInterventional Surgery
PG  - neurintsurg-2017-013219
4099  - http://jnis.bmj.com/content/early/2017/09/12/neurintsurg-2017-013219.short
4100  - http://jnis.bmj.com/content/early/2017/09/12/neurintsurg-2017-013219.full
AB  - Background The interval between the onset of cerebral vessel occlusion and recanalization has been shown to be an independent predictor of poor outcomes. However, endovascular recanalization of symptomatic cerebral vessel occlusion in the subacute period has not been well documented. We investigated the safety and efficacy of subacute recanalization of occluded cerebral vessels in patients with ischemic stroke or transient ischemic attacks (TIAs).Methods Between 2014 and 2015, 98 patients were admitted to the emergency room for ischemic stroke or TIA with a small infarct core, which was defined as modest early ischemic change on non-contrast CT or overt diffusion–perfusion mismatch. All patients underwent pre-transfemoral cerebral angiography and post-endovascular treatment. The patients were classified according to acute (onset-to-groin puncture time ≤6 hours) or subacute (onset-to-groin puncture time >6 hours) recanalization. Using propensity score analysis, recipients of acute and subacute recanalization underwent 1:1 matching.Results Following 1:1 propensity score matching, 32 patients who underwent acute and 32 who underwent subacute intra-arterial thrombolysis were matched. There were no significant differences in National Institutes of Health Stroke Scale at discharge, modified Rankin scale (mRS), the proportion of patients with an mRS value of 0–2, mortality at discharge, intracerebral bleeding, postprocedural infarct extension, newly detected infarction, and hyperintense acute reperfusion marker on follow-up images between the acute and subacute recanalization groups.Conclusions In selected patients with clinically unstable cerebral artery occlusions, a diffusion–perfusion mismatch and small CT lesions, subacute and acute recanalization has comparable safety and efficacy rates.