Influencing Factors of Recanalization after Intravenous Thrombolysis with Urokinase in Acute Cerebral Infarction Patients

Eur Neurol. 2020;83(2):162-166. doi: 10.1159/000507288. Epub 2020 May 27.

Abstract

Background: Intravenous thrombolysis (IVT) with urokinase is the standard reperfusion therapy for acute cerebral infarction (ACI) in China. Only about 30% patients who use urokinase for IVT can recanalize. Therefore, this study aimed to analyze the influencing factors of recanalization after IVT using urokinase in ACI patients.

Methods: A total of 391 consecutive patients with a diagnosis of ACI from January 2013 to October 2019 were enrolled and divided into 2 groups: patients without recanalization and patients with recanalization. Related data were collected and analyzed.

Results: Univariate analysis showed that there were significant differences in gender, atrial fibrillation, erythrocyte mean corpuscular volume, platelet large cell ratio (P-LCR), glucose (GLU), and severity of ICAS between patients without recanalization and patients with recanalization (p < 0.05). Multivariate logistic regression analysis indicated that P-LCR (odds ratio [OR] = 0.17, 95% confidence interval [CI] = 0.03-0.89, p = 0.04), GLU (OR = 0.28, 95% CI = 0.11-0.67, p = 0.004), and ICAS severity (OR = 0.48, 95% CI = 0.32-0.76, p = 0.001) were the influencing factors of recanalization.

Conclusion: For patients with higher levels of P-LCR, GLU, or ICAS severity, the recanalization rate might decrease after ACI.

Keywords: Acute cerebral infarction; Glucose; ICAS; Platelet large cell ratio; Recanalization; Urokinase.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravenous
  • Aged
  • Blood Glucose
  • Blood Platelets / pathology
  • Cerebral Infarction / drug therapy*
  • Cerebral Infarction / physiopathology
  • China
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Thrombolytic Therapy / methods*
  • Treatment Outcome
  • Urokinase-Type Plasminogen Activator / therapeutic use*

Substances

  • Blood Glucose
  • Fibrinolytic Agents
  • Urokinase-Type Plasminogen Activator