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논문 기본 정보

자료유형
학술저널
저자정보
Kwon Doo Hyuk (Department of Neurology Yeungnam University College of Medicine Daegu Korea.Department of Neurology) Jang Seong Hwa (Department of Neurology Keimyung University School of Medicine Daegu Korea.) Park Hyungjong (Department of Neurology Keimyung University School of Medicine Daegu Korea.) Sohn Sung-Il (Department of Neurology Keimyung University School of Medicine Daegu Korea.) Hong Jeong-Ho (Department of Neurology Keimyung University School of Medicine Daegu Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.37 No.19
발행연도
2022.5
수록면
1 - 10 (10page)
DOI
10.3346/jkms.2022.37.e156

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Background: Intravenous recombinant tissue plasminogen activator (IV rtPA) is the mainstay of treatment for acute ischemic stroke to recanalize thrombosed intracranial vessels within 4.5 hours. Emergency carotid artery stenting for the treatment of acute stroke due to stenoocclusion of the proximal internal carotid artery (ICA) can improve symptoms, prevent neurological deterioration, and reduce recurrent stroke risk. The feasibility and safety of the combination therapy of IV rtPA and urgent carotid artery stenting have not been established. Methods: From November 2005 to October 2020, we retrospectively assessed patients who had undergone emergent carotid artery stenting after IV rtPA for hyperacute ischemic stroke due to steno-occlusive proximal ICA lesion. Hemorrhagic transformation, successful recanalization, modified Rankin Scale (mRS) score at 90 days, and stent patency at 3 and 12 months or longer were evaluated. Favorable outcome was defined as a 90-days mRS score of ≤ 2. Results: Nineteen patients with hyperacute stroke had undergone emergent carotid artery stenting after IV rtPA therapy. Their median age was 70 (67.5?73.5) years (94.7% men). Among 15 patients with an additional intracranial occlusion after flow restoration in the proximal ICA, a modified TICI grade ≥ 2b was achieved in 11 patients (73.3%). Hemorrhagic transformation occurred in five patients (26.3%); mortality rate was 5.7%. Eleven patients (57.9%) had favorable outcomes at 90 days. Stent patients (94.1%) maintained stent patency for ≥ 12 months. Conclusion: We showed that emergent carotid artery stenting after IV rtPA therapy for hyperacute stroke caused by atherosclerotic proximal ICA steno-occlusion was feasible and safe.

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