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KMID : 1103720150730040230
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Journal of the Korean Society of Radiology
2015 Volume.73 No. 4 p.230 ~ p.239
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Intra-Arterial Therapy for Cardioembolic Internal Carotid Artery Terminus Occlusion: The Past and Present Status in Real Practice
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Jung Seung-Uk
Jung Cheol-Kyu
Kim Jae-Hyoung
Choi Byung-Se
Kim Beom-Joon
Han Moon-Ku
Bae Hee-Joon
Kwon Bae-Ju
Cha Sang-Hoon
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Abstract
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Purpose
There is little data on the effect of intra-arterial therapy (IAT) in acute cardioembolic internal carotid artery terminus (ICAT) occlusion that has poor prognosis. We determined procedural and clinical outcomes in patients with acute cardioembolic ICAT occlusion treated with different methods of IAT.
Materials and Methods
On retrospective review of our registry, patients with cardioembolic ICAT occlusion were categorized as thrombolytic-based IAT group (TLG) and thrombectomy-based IAT group (TEG) according to the primary endovascular technique. Subsequently, procedural and clinical outcomes were compared.
Results
Fifty-five patients had cardioembolic ICAT occlusion and 18 patients were assigned to TLG and 37 patients to TEG. The rate of complete reperfusion was significantly higher and the groin puncture to reperfusion time was significantly shorter in TEG than those in TLG. There was a trend towards functional outcome at 3 months in the TEG group; however, it was not statistically significant (p = 0.06). Age, baseline Albert Stroke program early CT score and puncture to reperfusion time were factors affecting unfavorable outcome at 3 months, on multivariable analysis.
Conclusion
Thrombectomy-based IAT has advantages over thrombolytic-based IAT in terms of the reduction of groin puncture to reperfusion time and improvement of the rate of complete reperfusion.
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KEYWORD
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Carotid Artery, Internal, Cerebral Infarction, Thrombectomy, Thrombolytic Therapy
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