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    J Korean Soc Radiol. 2016 Nov;75(5):346-353. Korean.
    Published online Oct 31, 2016.
    https://doi.org/10.3348/jksr.2016.75.5.346
    Copyright © 2016 The Korean Society of Radiology
    Original Article

    Clinical Experience of Intra-Arterial Therapy in Patients with Acute Ischemic Stroke from a Single Institute

    So Young Park, MD,1 Hanbin Lee, MD,2 Jonguk Kim, MD,2 Seung Hun Oh, MD,2 Jinkwon Kim, MD,2 Nam Keun Kim, PhD,3 Sang Heum Kim, MD,4 and Ok Joon Kim, MD2
      • 1Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.
      • 2Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
      • 3Institute for Clinical Research, School of Medicine, CHA University, Seongnam, Korea.
      • 4Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
    • Corresponding author: Ok Joon Kim, MD. Department of Neurology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea. Tel. 82-31-780-5481, Fax. 82-31-780-5269, Email: okjun77@cha.ac.kr
    Received February 16, 2016; Revised April 05, 2016; Accepted May 26, 2016.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    To compare the efficacy and safety between intra-arterial therapy (IAT) and intra-venous and intra-arterial combined therapy (IVIACT) in patients with acute ischemic stroke in the anterior circulation territory.

    Materials and Methods

    Forty-one patients treated with IAT using Solitaire were retrospectively reviewed. Nineteen patients were treated with IAT, twenty-two patients were treated with IVIACT, and ten patients of the forty-one patients were managed with multimodal treatment like stent, balloon angioplasty etc. We investigated the rate of recanalization and hemorrhage, NIH stroke scale and 3-month modified Rankin Scale.

    Results

    The overall recanalization rate was 93% and symptomatic ICH occurred in 10% of the patients. There was no difference in hemorrhage, recanalization rate, and early improvement between IAT and IVIACT. Good outcome was more frequently observed in 59% of the patients with IVIACT than 36% of the patients treated with IAT without any significant difference. The patients managed with multimodal treatment did not show any significant hemorrhage outcome.

    Conclusion

    IAT using Solitaire is a useful treatment method without high risk in patients with acute ischemic stroke in the anterior circulation territory. Also, IVIACT and multimodal treatment might be considered as reasonable therapeutic options in these patients.

    Keywords
    Stroke; Mechanical Thrombolysis; Tissue Plasminogen Activator

    Tables

    Table 1
    Clinical Characteristics of the Patients

    Table 2
    Comparison of Outcome between IAT and IVIACT

    Table 3
    The Clinical Characteristics, Detailed Intervention, and Outcome of the Patients Receiving Multimodal Treatment

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    MeSH Terms
    Angioplasty, Balloon
    Combined Modality Therapy
    Hemorrhage
    Humans
    Mechanical Thrombolysis
    Methods
    Retrospective Studies
    Stents
    Stroke*
    Tissue Plasminogen Activator
    Metrics
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