![]() ![]() 3 – 13 As with systemic thrombolytics, endovascular treatments for acute ischemic stroke carry the risk of intracranial bleeding. 2, 3 Because of these limitations, catheter-based approaches for acute ischemic stroke have been developed to directly infuse thrombolytics at the site of the thrombus or mechanically extract and disrupt the clot. ![]() 1, 2 However, IV tPA has limited ability to open occlusions of medium and large arteries such as the internal carotid artery, proximal middle cerebral artery, or basilar artery, with recanalization rates reported as low as 10%. 1 A meta-analysis of 53 studies including 2066 patients with acute stroke demonstrated a 46.2% overall recanalization rate with IV fibrinolysis. Intravenous tissue plasminogen activator has been proven to be efficacious in recanalization of occluded intracranial vessels and improvement of clinical outcome for acute ischemic stroke. Angiographic vasospasm was common but without clinical sequelae. 65), and major groin complications (3.6% versus 7.9% P =. 07), air emboli (1.8% versus 1.1% P = 1.0), emboli to new vascular territories (1.8% versus 0% P =. Comparing the Merci with the Solitaire FR retrieval device, we observed symptomatic cerebral hemorrhage (10.9% versus 1.1% P =. We did not observe any statistically significant associations of peri-procedural complications with age type of treatment center duration of stroke symptoms NIHSS score, IV thrombolytics, atrial fibrillation, site of vessel occlusion rescue therapy administered after endovascular treatment or device. Rates of symptomatic intracranial bleeding by subtype were PH1, 0.7% PH2, 0.7% (PH1 indicates hematoma within ischemic field with some mild space-occupying effect but involving ≤30% of the infarcted area PH2, hematoma within ischemic field with space-occupying effect involving >30% of the infarcted area) intracranial hemorrhage remote from ischemic zone, 0% intraventricular hemorrhage, 0.7% and SAH, 3.5%. Major peri-procedural complications occurred in 18 of 144 patients (12.5%) as follows: symptomatic intracranial hemorrhage, 4.9% air emboli, 1.4% vessel dissection, 4.2% major groin complications, 2.8% and emboli to new vascular territories, 0.7%. ![]()
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