Acute stroke intervention by interventional cardiologists

DeVries, James T., White, Christopher J., Collins, Tyrone J., Jenkins, J. Stephen, Reilly, John P., Grise, Mark A., McMullan, Paul W., Badawi, Ramy A. and Ramee, Stephen R. (2009) Acute stroke intervention by interventional cardiologists. Catheterization and Cardiovascular Interventions, 73 5: 692-698.


Author DeVries, James T.
White, Christopher J.
Collins, Tyrone J.
Jenkins, J. Stephen
Reilly, John P.
Grise, Mark A.
McMullan, Paul W.
Badawi, Ramy A.
Ramee, Stephen R.
Title Acute stroke intervention by interventional cardiologists
Journal name Catheterization and Cardiovascular Interventions   Check publisher's open access policy
ISSN 1522-1946
1522-726X
Publication date 2009-04-01
Year available 2008
Sub-type Article (original research)
DOI 10.1002/ccd.21927
Volume 73
Issue 5
Start page 692
End page 698
Total pages 7
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Formatted abstract Objectives: To report the technical success and clinical outcomes of catheter-based therapy (CBT) for acute ischemic stroke in patients ineligible for intravenous thrombolysis.
Background: Acute ischemic stroke is common but undertreated. CBT for acute ischemic stroke is a therapeutic option in selected patients who are not candidates for intravenous thrombolysis.
Methods: Consecutive stroke patients who were ineligible for intravenous thrombolysis and underwent CBT were identified by retrospective chart review. Demographic information, National Institutes of Health Stroke Scale (NIHSS), procedural characteristics, and clinical outcomes during hospitalization and at 90 days follow up were collected. Experienced interventional cardiologists with the consultative support of stroke neurologists were on call for acute strokes.
Results: A total of 33 acute ischemic stroke patients underwent emergency cerebral angiography, with 26 patients undergoing CBT. Successful “culprit” artery recanalization was achieved in 23 (88%) of the 26 patients. In-hospital adverse events occurred in 4 (15%) patients, with intracerebral hemorrhage (ICH) (12%) representing the most common adverse event. The baseline NIHSS for patients who underwent intervention was 16.5 ± 9.9 (median 16) and improved significantly to 9.9 ± 8.7 (median 9) (P < 0.001) at hospital discharge. A modified Rankin score of two or less (indicating mild disability) was achieved in half (n = 13) of the CBT treated patients. All cause mortality at 90 days was 8% (2/26).
Conclusions: In selected patients, CBT provided by qualified interventional cardiologists supported by stroke neurologists, offers a safe and effective option for patients with acute stroke who are not eligible for intravenous thrombolysis.
Keyword Peripheral vascular disease
Thrombosis
Embolization
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Article first published online: 16 DEC 2008

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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