Recanalization of occluded large arteries with broadened therapeutic window for acute cerebral infarction

Abstract

Objective: To investigate the safety and efficacy of recanalization with a broadened therapeutic window for acute occlusion of large cerebral arteries.

Methods: We assessed 38 patients who underwent the hyper-selective intra-arterial administration of low-dose urokinase, along with mechanical thrombus disruption or mechanical thrombus disruption recanalization (34 stents in 33 patients) of occluded vessels, 20 with onset time-to-treatment (OTT) >6 h (observation group; mean OTT, 20.10±15.67 h) and 18 with OTT ≤6 h (control group). NIHSS scores, mRS scores (≤2) at 3 months, recanalization rates, severe cerebral infarctions on CT, and symptomatic hemorrhagic conversions after surgery were compared.

Results: Postoperative recanalization rates were 100% in both groups, and other results were equivalent.

Conclusions: Recanalization at longer OTT was safe and effective with acute occlusions of large cerebral arteries. Time to recanalization could be safely prolonged for up to 20 h in these patients.