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Angioplasty as an Adjuvant Therapy for the Treatment of Acute Ischemic Stroke

Published online by Cambridge University Press:  02 December 2014

Mohammed Alhazzaa ,
Amanda Murphy ,
Cheemun Lum ,
Marlise P. dos Santos ,
Howard Lesiuk  and
Miguel Bussière
Mohammed Alhazzaa
Affiliation:
Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa
Amanda Murphy
Affiliation:
Department of Medical Imaging, London Health Sciences Centre, London, Ontario, Canada
Cheemun Lum
Affiliation:
Department of Diagnostic Imaging, Section of Interventional Neuroradiology, The Ottawa Hospital, Ottawa
Marlise P. dos Santos
Affiliation:
Department of Diagnostic Imaging, Section of Interventional Neuroradiology, The Ottawa Hospital, Ottawa
Howard Lesiuk
Affiliation:
Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa
Miguel Bussière*
Affiliation:
Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa Department of Diagnostic Imaging, Section of Interventional Neuroradiology, The Ottawa Hospital, Ottawa
*
Neurology and Interventional Neuroradiology, The Ottawa Hospital, Civic campus, C2, Room 2174, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada
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Abstract:

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Background:

Different endovascular techniques can be employed to achieve vessel recanalization in acute stroke. We assessed whether an endovascular strategy that included angioplasty was safe and effectively recanalized acutely occluded intracranial vessels.

Methods:

We retrospectively reviewed 70 patients that received intra-arterial therapy for acute stroke. Patients were divided into two groups depending on whether they had received angioplasty as part of their endovascular treatment.

Results:

Angioplasty was used in the treatment of 35/70 patients (50%). Median baseline NIHSS was 15. The site of occlusion was at the M1 in 11 patients, M1/M2 in 3, ICA/M1 in 13 and vertebrobasilar in 8 patients. Intravenous thrombolysis was administered to 16/35 patients (46%). Angioplasty was used alone in 4 patients, in combination with intra-arterial thrombolysis in 27 and with a mechanical retrieval device or stent in 13 patients. Recanalization (TICI 2-3) was achieved in 23/35 patients (66%). Median time from symptom onset to recanalization was six hours. In patients where angioplasty was employed, symptomatic intracranial hemorrhage occurred in 2/35 (6%), which was similar to patients that were not treated with angioplasty. A favorable functional outcome (mRS=2) was achieved in 20% (7/35) at 24 hour and 34% (12/35) at one month. All patients that had a favorable outcome had recanalized.

Conclusion:

In this small cohort, an endovascular treatment strategy that employed angioplasty was safe and effectively recanalized acutely occluded intracranial vessels. Angioplasty should be considered as a potential treatment option in interventional acute stroke trials.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 4 , July 2011 , pp. 593 - 599
Copyright
Copyright © The Canadian Journal of Neurological 2011

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