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From the Department of Neurology (M.T.W., M.G.), University Hospital Magdeburg; Department of Neurology (T.P.), St.-Vincenz-Krankenhaus Paderborn; Department of Neurology (E. Schmitt), Katholisches Klinikum, Koblenz; Department of Neurology (G.S.), Univ. Hospital Schleswig-Holstein, Campus Luebeck; Department of Neurology (G.G.), Klinikum Carl Gustav Carus, Technical Univ. Dresden; Department of Neurology (C.S.), Alfried-Krupp-Krankenhaus Essen; and Department of Neurology (E. Stolz), Justus-Liebig-University Giessen, Germany.
Address correspondence and reprint requests to Priv.-Doz. Dr. med. Erwin Stolz, Department of Neurology, Justus-Liebig-University Giessen, Am Steg 14, 35385 Giessen, Germany Erwin.stolz{at}neuro.med.uni-giessen.de
Background: To evaluate the time course of major vessel recanalization under IV thrombolysis in relation to functional outcome in acute ischemic stroke.
Methods: A total of 99 patients with an acute anterior circulation vessel occlusion who underwent IV thrombolysis were included. All patients had a standardized admission and follow-up procedure. Color-coded duplex sonography was performed on admission, 30 minutes after thrombolysis, and at 6 and 24 hours after onset of symptoms. Recanalization was classified as complete, partial, and absent. Functional outcome was rated with the modified Rankin Scale on day 30.
Results: Complete recanalization occurred significantly more frequently in patients with multiple branch occlusions compared to those with mainstem occlusion (OR 5.33; 95% CI, 2.18 to 13.05; p < 0.0001) and was associated with lower NIH Stroke Scale (NIHSS) scores (p < 0.001). Not the specific time point of recanalization at 6 or 24 hours after stroke onset, but recanalization per se within 24 hours (OR 7.8; 95% CI 2.2 to 28.2; p = 0.002) was significantly associated with a favorable outcome. Multivariate analysis revealed recanalization at any time within 24 hours and NIHSS scores on days 1 and 7 together explaining 75% of the functional outcome variance 30 days after stroke.
Conclusions: Complete recanalization up to 24 hours after stroke onset is significantly associated with the short-term clinical course and functional outcome 30 days after acute stroke.
Editorial, see page 1335
Received August 11, 2006. Accepted in final form February 2, 2007.
Disclosure: All authors are members of the Ultrasound Subnet of the Competence Network Stroke and received funding by the German Federal Ministry of Education and Research (BMBF).
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Neurology 2007 68: 1335-1336.
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