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Recanalisation of middle cerebral artery occlusion after intra-arterial thrombolysis: different recanalisation grading systems and clinical functional outcome
- Publication Year :
- 2005
- Publisher :
- BMJ Group, 2005.
-
Abstract
- Different grading systems of arterial recanalisation have never been compared in large series of stroke patients treated with intra-arterial thrombolysis (IAT).Clinical and angiographic findings and outcome were analysed in 147 patients with M1 or M2 segment occlusion of the middle cerebral artery treated with IAT. Associations of the thrombolysis in myocardial infarction (TIMI) grading system and the Mori grading system with clinical outcome were compared.The median NIHSS score on admission was 15 and the mean time from symptom onset to IAT was 242 minutes. After three months the outcome was favourable (defined as modified Rankin scale score (mRS)or = 2) in 85 patients (58%) and poor (mRS 3 to 5) in 44 (30%); 18 patients (12%) were dead. Recanalisation was categorised as TIMI grade 0 in 17 patients (12%), TIMI 1 in 16 (11%), TIMI 2 in 83 (56%), and TIMI 3 in 31(21%). Seventeen patients (12%) showed Mori grade 0 reperfusion, 16 (11%) Mori 1, 37 (25%) Mori 2, 46 (31%) Mori 3, and 31 (21%) Mori 4. In both TIMI and Mori grading systems, reopening the artery was an independent predictor of a favourable clinical outcome (p0.0001). When recanalisation was partial, outcome was better in patients with reperfusion50% (Mori 3) than in those with reperfusion50% (Mori 2) (p = 0.008).Both TIMI and Mori grading systems are useful for predicting outcome after stroke and IAT. When recanalisation is partial the Mori classification is more refined in giving prognostic information.
- Subjects :
- Paper
Adult
Male
medicine.medical_specialty
Time Factors
Adolescent
medicine.medical_treatment
Infarction
Severity of Illness Index
Fibrinolytic Agents
Modified Rankin Scale
Internal medicine
medicine.artery
Occlusion
medicine
Humans
Infusions, Intra-Arterial
cardiovascular diseases
Myocardial infarction
Aged
Aged, 80 and over
business.industry
fungi
Infarction, Middle Cerebral Artery
Thrombolysis
Middle Aged
medicine.disease
Urokinase-Type Plasminogen Activator
Surgery
Psychiatry and Mental health
Treatment Outcome
Middle cerebral artery
Reperfusion
Cardiology
Female
Neurology (clinical)
business
Fibrinolytic agent
TIMI
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....a85622bbd72425b4b938ae4afbd1e2a5