dc.contributor.author |
Tsivgoulis, Georgios |
|
dc.contributor.author |
Saqqur, Maher |
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dc.contributor.author |
Sharma, Vijay K. |
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dc.contributor.author |
Brunser, Alejandro |
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dc.contributor.author |
Eggers, Jürgen |
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dc.contributor.author |
Mikulik, Robert |
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dc.contributor.author |
Katsanos, Aristeidis H. |
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dc.contributor.author |
Sergentanis, Theodore N. |
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dc.contributor.author |
Vadikolias, Konstantinos |
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dc.contributor.author |
Perren, Fabienne |
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dc.contributor.author |
Rubiera, Marta |
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dc.contributor.author |
Shahripour, Reza Bavarsad |
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dc.contributor.author |
Nguyen, Huy Thang |
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dc.contributor.author |
Martínez-Sánchez, Patricia |
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dc.contributor.author |
Safouris, Apostolos |
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dc.contributor.author |
Heliopoulos, Ioannis |
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dc.contributor.author |
Shuaib, Ashfaq |
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dc.contributor.author |
Derksen, Carol |
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dc.contributor.author |
Voumvourakis, Konstantinos |
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dc.contributor.author |
Psaltopoulou, Theodora |
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dc.contributor.author |
Alexandrov, Anne W. |
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dc.contributor.author |
Alexandrov, Andrei V. |
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dc.contributor.author |
CLOTBUST-PRO investigators |
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dc.date.accessioned |
2021-08-06T15:50:16Z |
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dc.date.available |
2021-08-06T15:50:16Z |
|
dc.date.issued |
2020 |
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dc.identifier.citation |
Journal of Stroke, 2020, vol.22(1):130-140 |
es |
dc.identifier.uri |
https://doi.org/10.5853/jos.2019.01648 |
es |
dc.identifier.uri |
http://hdl.handle.net/11447/4248 |
|
dc.description.abstract |
Background and Purpose
Although onset-to-treatment time is associated with early clinical recovery in acute ischemic stroke (AIS) patients treated with intravenous tissue plasminogen activator (tPA), the effect of the timing of tPA-induced recanalization on functional outcomes remains debatable.
Methods
We conducted a multicenter, prospective observational cohort study to determine whether early (within 1-hour from tPA-bolus) complete or partial recanalization assessed during 2-hour real-time transcranial Doppler monitoring is associated with improved outcomes in patients with proximal occlusions. Outcome events included dramatic clinical recovery (DCR) within 2 and 24-hours from tPA-bolus, 3-month mortality, favorable functional outcome (FFO) and functional independence (FI) defined as modified Rankin Scale (mRS) scores of 0-1 and 0-2 respectively.
Results
We enrolled 480 AIS patients (mean age 66±15 years, 60% men, baseline National Institutes of Health Stroke Scale score 15). Patients with early recanalization (53%) had significantly (jos-2019-01648P<0.001) higher rates of DCR at 2-hour (54% vs. 10%) and 24-hour (63% vs. 22%), 3-month FFO (67% vs. 28%) and FI (81% vs. 39%). Three-month mortality rates (6% vs. 17%) and distribution of 3-month mRS scores were significantly lower in the early recanalization group. After adjusting for potential confounders, early recanalization was independently associated with higher odds of 3-month FFO (odds ratio [OR], 6.19; 95% confidence interval [CI], 3.88 to 9.88) and lower likelihood of 3-month mortality (OR, 0.34; 95% CI, 0.17 to 0.67). Onset to treatment time correlated to the elapsed time between tPA-bolus and recanalization (unstandardized linear regression coefficient, 0.13; 95% CI, 0.06 to 0.19).
Conclusions
Earlier tPA treatment after stroke onset is associated with faster tPA-induced recanalization. Earlier onset-to-recanalization time results in improved functional recovery and survival in AIS patients with proximal intracranial occlusions. |
es |
dc.language.iso |
en |
es |
dc.subject |
Thrombolysis |
es |
dc.subject |
Stroke |
es |
dc.subject |
Reperfusion |
es |
dc.subject |
Outcomes |
es |
dc.title |
Timing of Recanalization and Functional Recovery in Acute Ischemic Stroke |
es |
dc.type |
Article |
es |