Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas
Introduction. In acute stroke by occlusion of the proximal medial cerebral artery (MCA) or the distal internal carotid artery, intravenous thrombolysis is an established treatment. Another option is mechanical recanalization. It remains unclear if the combination of both methods poses an additional...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2015-01-01
|
| Series: | Radiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2015/159815 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832561509101731840 |
|---|---|
| author | J. Höltje F. Bonk A. Anstadt C. Terborg C. Pohlmann P. P. Urban R. Brüning |
| author_facet | J. Höltje F. Bonk A. Anstadt C. Terborg C. Pohlmann P. P. Urban R. Brüning |
| author_sort | J. Höltje |
| collection | DOAJ |
| description | Introduction. In acute stroke by occlusion of the proximal medial cerebral artery (MCA) or the distal internal carotid artery, intravenous thrombolysis is an established treatment. Another option is mechanical recanalization. It remains unclear if the combination of both methods poses an additional bleeding risk. The aim of this retrospective analysis is to determine the proportion of hemorrhagic infarctions and parenchymal hematomas. Methods. Inclusion criteria were an occlusion of the carotid T or proximal MCA treated with full dose thrombolysis and mechanical recanalization. 31 patients were selected. Devices used were Trevo, Penumbra Aspiration system, Penumbra 3D Retriever, and Revive. The initial control by computed tomography was carried out with a mean delay to intervention of 10.9 hours (SD: 8.5 hours). Results. A slight hemorrhagic infarction (HI1) was observed in 2/31 patients, and a more severe HI2 occurred in two cases. A smaller parenchymal hematoma (PH1) was not seen and a space-occupying PH2 was seen in 2/31 cases. There was no significant difference in the probability of intracranial bleeding after successful (thrombolysis in cerebral infarctions 2b and 3) or unsuccessful recanalization. Conclusion. The proportion of intracranial bleeding using mechanical recanalization following intravenous thrombolysis appears comparable with reports using thrombolysis alone. |
| format | Article |
| id | doaj-art-894a5aa0038042eda752a9f26c5ac157 |
| institution | Kabale University |
| issn | 2090-1941 2090-195X |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Radiology Research and Practice |
| spelling | doaj-art-894a5aa0038042eda752a9f26c5ac1572025-02-03T01:24:52ZengWileyRadiology Research and Practice2090-19412090-195X2015-01-01201510.1155/2015/159815159815Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal HematomasJ. Höltje0F. Bonk1A. Anstadt2C. Terborg3C. Pohlmann4P. P. Urban5R. Brüning6Institute of Radiology and Neuroradiology, Asklepios Hospital Barmbek, Hamburg, GermanyInstitute of Radiology and Neuroradiology, Asklepios Hospital Barmbek, Hamburg, GermanyInstitute of Radiology and Neuroradiology, Asklepios Hospital Barmbek, Hamburg, GermanyDepartment of Neurology, Asklepios Hospital St. Georg, Hamburg, GermanyDepartment of Neurology, Asklepios Hospital Barmbek, Hamburg, GermanyDepartment of Neurology, Asklepios Hospital Barmbek, Hamburg, GermanyInstitute of Radiology and Neuroradiology, Asklepios Hospital Barmbek, Hamburg, GermanyIntroduction. In acute stroke by occlusion of the proximal medial cerebral artery (MCA) or the distal internal carotid artery, intravenous thrombolysis is an established treatment. Another option is mechanical recanalization. It remains unclear if the combination of both methods poses an additional bleeding risk. The aim of this retrospective analysis is to determine the proportion of hemorrhagic infarctions and parenchymal hematomas. Methods. Inclusion criteria were an occlusion of the carotid T or proximal MCA treated with full dose thrombolysis and mechanical recanalization. 31 patients were selected. Devices used were Trevo, Penumbra Aspiration system, Penumbra 3D Retriever, and Revive. The initial control by computed tomography was carried out with a mean delay to intervention of 10.9 hours (SD: 8.5 hours). Results. A slight hemorrhagic infarction (HI1) was observed in 2/31 patients, and a more severe HI2 occurred in two cases. A smaller parenchymal hematoma (PH1) was not seen and a space-occupying PH2 was seen in 2/31 cases. There was no significant difference in the probability of intracranial bleeding after successful (thrombolysis in cerebral infarctions 2b and 3) or unsuccessful recanalization. Conclusion. The proportion of intracranial bleeding using mechanical recanalization following intravenous thrombolysis appears comparable with reports using thrombolysis alone.http://dx.doi.org/10.1155/2015/159815 |
| spellingShingle | J. Höltje F. Bonk A. Anstadt C. Terborg C. Pohlmann P. P. Urban R. Brüning Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas Radiology Research and Practice |
| title | Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas |
| title_full | Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas |
| title_fullStr | Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas |
| title_full_unstemmed | Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas |
| title_short | Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas |
| title_sort | mechanical recanalization following i v thrombolysis a retrospective analysis regarding secondary hemorrhagic infarctions and parenchymal hematomas |
| url | http://dx.doi.org/10.1155/2015/159815 |
| work_keys_str_mv | AT jholtje mechanicalrecanalizationfollowingivthrombolysisaretrospectiveanalysisregardingsecondaryhemorrhagicinfarctionsandparenchymalhematomas AT fbonk mechanicalrecanalizationfollowingivthrombolysisaretrospectiveanalysisregardingsecondaryhemorrhagicinfarctionsandparenchymalhematomas AT aanstadt mechanicalrecanalizationfollowingivthrombolysisaretrospectiveanalysisregardingsecondaryhemorrhagicinfarctionsandparenchymalhematomas AT cterborg mechanicalrecanalizationfollowingivthrombolysisaretrospectiveanalysisregardingsecondaryhemorrhagicinfarctionsandparenchymalhematomas AT cpohlmann mechanicalrecanalizationfollowingivthrombolysisaretrospectiveanalysisregardingsecondaryhemorrhagicinfarctionsandparenchymalhematomas AT ppurban mechanicalrecanalizationfollowingivthrombolysisaretrospectiveanalysisregardingsecondaryhemorrhagicinfarctionsandparenchymalhematomas AT rbruning mechanicalrecanalizationfollowingivthrombolysisaretrospectiveanalysisregardingsecondaryhemorrhagicinfarctionsandparenchymalhematomas |