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Volume : 23 Issue : 3 Year : 2017

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Efficiency of Intravenous Thrombolytic Therapy in Isolated Middle Cerebral Artery Occlusions: A CT Angiography Study [Turk J Neurol]
Turk J Neurol. Ahead of Print: TJN-23921

Efficiency of Intravenous Thrombolytic Therapy in Isolated Middle Cerebral Artery Occlusions: A CT Angiography Study

Ezgi Sezer Eryıldız, Atilla Özcan Özdemir
Department Of Neurology, Eskişehir Osmangazi University, Medical Faculty, Eskişehir, Turkey

Objective: We aimed to evaluate the outcomes of two groups of acute ischemic stroke patients treated with intravenous recombinant tissue plasminogen activator (IV rt-PA); those with isolated middle cerebral artery (MCA) occlusion and those without any large vessel occlusion.
Materials and Methods: Data of patients with treated with IV rt-PA within 4,5 hours of symptom onset were analyzed from March 2015 to January 2017, retrospectively. Patients were divided into two groups; those with isolated MCA occlusion and those without any large vessel occlusion. Large vessel occlusion was detected with contrast-enhanced CT angiography (CTA) performed before IV rt-PA. Additionally, demographic and clinical data of the patients were analyzed. Clinical outcomes of the patients were determined by the modified Rankin Scale (mRS) score at 3 months after treatment.
Results: A total of 69 patients were included in the study. Isolated MCA occlusion was observed in 28 (40.6 %) of them. The rate of very good outcome (mRS 0-1) was 46.4 % whereas the rate of poor outcome (mRS 3-6) was 42.9 % in the group with isolated MCA occlusion. Moreover, in the other group, the rate of very good outcome and poor outcome were 65.9 % and 26.8 %, respectively.
Conclusion: In acute ischemic stroke with isolated MCA occlusion, due to the favorable outcomes of the patients, IV rt-PA continues to be the best treatment option in cases where endovascular treatment options can not be performed and it should be applied by the clinician in appropriate cases without delay.

Keywords: acute stroke, middle cerebral artery, occlusion, rt-PA, outcome




Corresponding Author: Ezgi Sezer Eryıldız, Türkiye


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