тромболизис при инсульте

[vladmokh]

Уважаемые коллеги, вот на днях появилась новая инфа об интраартериальном тромболизисе:
Long-Term Effect of Intra-Arterial Thrombolysis in Stroke

Krassen Nedeltchev MD; Urs Fischer MD; Marcel Arnold MD; Pietro Ballinari MSc; Tobias Haefeli MD; Liliane Kappeler MD; Caspar Brekenfeld MD; Luca Remonda MD; Gerhard Schroth MD; and Heinrich P. Mattle MD*
From Departments of Neurology (K.N., U.F., M.A., L.K., T.H., H.P.M.), Diagnostic and Interventional Neuroradiology (C.B., L.R., G.S.), and Psychology (P.B.), University of Bern, Switzerland.
* To whom correspondence should be addressed. E-mail: [Ссылки доступны только зарегистрированным пользователям ]

Background and Purpose--Thrombolysis has been shown to improve the 3-month outcome of patients with ischemic stroke, but knowledge of the long-term effect of thrombolysis is limited.

Methods--The present study compares the long-term outcome of stroke patients who were treated with intra-arterial thrombolysis (IAT) using urokinase with the outcome of patients treated with aspirin. The modified Rankin Scale (mRS) was used to assess the outcome; 173 patients treated with IAT and 261 patients treated with aspirin from the Bernese Stroke Data Bank were eligible for the study. A matching algorithm taking into account patient age and stroke severity on admission (as measured by the National Institute of Health Stroke Scale [NIHSS]) was used to assemble an IAT and an aspirin group.

Results--One hundred and forty-four patients treated with IAT and 147 patients treated with aspirin could be matched and included in the comparative analysis. The median NIHSS score was 14 in each group. At 2 years, 56% of the patients treated with IAT and 42% of the patients treated with aspirin achieved functional independence (mRS, 0 to 2; P=0.037). Clinical outcome was excellent (mRS, 0 to 1) in 40% of the IAT and in 24% of the aspirin patients (P=0.008). Mortality was 23% and 24%, respectively.

Conclusions --The present study provides evidence for a sustained effect of IAT when assessed 2 years after the stroke.