Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Stroke. 2013 Sep;15(3):182-8. doi: 10.5853/jos.2013.15.3.182. Epub 2013 Sep 27.

Repeated thrombolytic therapy in patients with recurrent acute ischemic stroke.

Author information

  • 1Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE:

Widespread use of thrombolytic treatments, along with improved chances of survival after an initial ischemic stroke, increases the possibility of repeated thrombolysis. There are few reports, however, regarding repeated thrombolysis in patients who have suffered acute ischemic stroke. We explored the number and outcome of patients with repeated thrombolytic therapy in the era of multimodal thrombolytic treatments.

METHODS:

We investigated patients with acute ischemic stroke who had received thrombolytic treatments for a period of 10 years. Number of thrombolysis was determined in each patient. Recanalization was defined as Thrombolysis in Cerebral Infarction grading ≥2a. Symptomatic hemorrhagic transformation was defined as any increase in the National Institutes of Health Stroke Scale score that could be attributed to intracerebral hemorrhage. A good outcome was defined as a modified Rankin scale score ≤2.

RESULTS:

Of the 437 patients who received thrombolytic treatments, only 7 underwent repeated thrombolysis (1.6%). The median age at the time of repeated thrombolytic therapy was 71 years old; 4 of the patients were female. All patients had 1 or more potential sources of cardiac embolism. Recanalization was achieved in all patients, in both the first and the second thrombolysis. No symptomatic intracranial hemorrhage occurred after repeated thrombolytic treatments. Five patients (71.4%) showed good outcomes at 3 months.

CONCLUSIONS:

Repeated thrombolysis for recurrent acute ischemic stroke appears to be safe and feasible. Among patients who experience recurrent acute ischemic stroke, thrombolytic therapy could be considered even if the patient has had previous thrombolytic treatments.

KEYWORDS:

Acute ischemic stroke; Outcome; Recurrence; Thrombolysis

PMID:
24396812
[PubMed]
PMCID:
PMC3859005
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Korean Stroke Society Icon for PubMed Central
    Loading ...
    Write to the Help Desk