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A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke

The New England journal of medicine, 2015-01, Vol.372 (1), p.11-20 [Peer Reviewed Journal]

Copyright © 2015 Massachusetts Medical Society. All rights reserved. ;ISSN: 0028-4793 ;EISSN: 1533-4406 ;DOI: 10.1056/NEJMoa1411587 ;PMID: 25517348

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Title:
A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke
Author: Berkhemer, Olvert A ; Fransen, Puck S.S ; Beumer, Debbie ; van den Berg, Lucie A ; Lingsma, Hester F ; Yoo, Albert J ; Schonewille, Wouter J ; Vos, Jan Albert ; Nederkoorn, Paul J ; Wermer, Marieke J.H ; van Walderveen, Marianne A.A ; Staals, Julie ; Hofmeijer, Jeannette ; van Oostayen, Jacques A ; Lycklama à Nijeholt, Geert J ; Boiten, Jelis ; Brouwer, Patrick A ; Emmer, Bart J ; de Bruijn, Sebastiaan F ; van Dijk, Lukas C ; Kappelle, L. Jaap ; Lo, Rob H ; van Dijk, Ewoud J ; de Vries, Joost ; de Kort, Paul L.M ; van Rooij, Willem Jan J ; van den Berg, Jan S.P ; van Hasselt, Boudewijn A.A.M ; Aerden, Leo A.M ; Dallinga, René J ; Visser, Marieke C ; Bot, Joseph C.J ; Vroomen, Patrick C ; Eshghi, Omid ; Schreuder, Tobien H.C.M.L ; Heijboer, Roel J.J ; Keizer, Koos ; Tielbeek, Alexander V ; den Hertog, Heleen M ; Gerrits, Dick G ; van den Berg-Vos, Renske M ; Karas, Giorgos B ; Steyerberg, Ewout W ; Flach, H. Zwenneke ; Marquering, Henk A ; Sprengers, Marieke E.S ; Jenniskens, Sjoerd F.M ; Beenen, Ludo F.M ; van den Berg, René ; Koudstaal, Peter J ; van Zwam, Wim H ; Roos, Yvo B.W.E.M ; van der Lugt, Aad ; van Oostenbrugge, Robert J ; Majoie, Charles B.L.M ; Dippel, Diederik W.J
Subjects: Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Arterial catheterization ; Brain Ischemia - drug therapy ; Brain Ischemia - therapy ; Cardiac patients ; Care and treatment ; Catheterization ; Cerebral blood flow ; Clinical trials ; Combined Modality Therapy ; Evidence-based medicine ; Female ; Fibrinolytic Agents - therapeutic use ; Health aspects ; Hemorrhage ; Humans ; Implants ; Intravenous administration ; Ischemia ; Logistic Models ; Male ; Mechanical Thrombolysis ; Medical imaging ; Medical treatment ; Middle Aged ; Odds Ratio ; Patients ; Risk factors ; Single-Blind Method ; Stroke ; Stroke (Disease) ; Stroke - drug therapy ; Stroke - therapy ; Tissue Plasminogen Activator - therapeutic use ; Urokinase-Type Plasminogen Activator - therapeutic use ; Veins & arteries
Is Part Of: The New England journal of medicine, 2015-01, Vol.372 (1), p.11-20
Description: In patients with acute ischemic stroke due to a proximal intracranial arterial occlusion, intraarterial treatment (with retrievable stents in 82% of patients) within 6 hours improved functional outcome at 90 days. Alteplase was given to 89% of patients before randomization. Intravenous alteplase administered within 4.5 hours after symptom onset is the only reperfusion therapy with proven efficacy in patients with acute ischemic stroke. 1 However, well-recognized limitations of this therapy include the narrow therapeutic time window and contraindications such as recent surgery, coagulation abnormalities, and a history of intracranial hemorrhage. 2 Moreover, intravenous alteplase appears to be much less effective at opening proximal occlusions of the major intracranial arteries, which account for more than one third of cases of acute anterior-circulation stroke. 3 , 4 Early recanalization after intravenous alteplase is seen in only about one third of patients with an occlusion of the . . .
Publisher: United States: Massachusetts Medical Society
Language: English
Identifier: ISSN: 0028-4793
EISSN: 1533-4406
DOI: 10.1056/NEJMoa1411587
PMID: 25517348
Source: ProQuest One Psychology
AUTh Library subscriptions: ProQuest Central
MEDLINE
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A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke

Copyright © 2015 Massachusetts Medical Society. All rights reserved. ;ISSN: 0028-4793 ;EISSN: 1533-4406 ;DOI: 10.1056/NEJMoa1411587 ;PMID: 25517348

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