• Emilie M M Santos
  • Jan Willem Dankbaar
  • Kilian M. Treurniet
  • Alexander D. Horsch
  • Yvo B. Roos
  • L. Jaap Kappelle
  • Wiro J. Niessen
  • Charles B. Majoie
  • Birgitta Velthuis
  • Henk A. Marquering

Background and Purpose - Preclinical studies showed that thrombus permeability improves recombinant tissue-type plasminogen activator (r-tPA) efficacy. We hypothesize that thrombus permeability estimated from radiological imaging is associated with improved recanalization after treatment with intravenously administered r-tPA (r-tPA) and with better functional outcome. Methods - We assessed thrombus attenuation increase (TAI) in patients from the Dutch Acute Stroke Study with an occlusion of an intracranial artery on computed tomographic angiography. Patients were included within 9 hours after the stroke onset. After dichotomization of TAI as pervious or impervious, logistic regressions analyses were performed to estimate associations of intravenous r-tPA therapy with complete recanalization and with favorable functional outcome (modified Rankin Scale score of ≤2). Results - Three hundred eight patients matched the inclusion criteria. The median TAI was 20.1 (interquartile range, 8.5-37.8) Hounsfield unit (HU). We found a significant increase in the odds of complete recanalization with increasing TAI for patients treated with intravenous r-tPA (P=0.030). One hundred thirty-one (42%) thrombi were classified as pervious with TAI of ≥23 HU. In patients with a pervious thrombus, complete recanalization was more frequent after treatment with intravenous r-tPA than after conservative treatment (odds ratio, 6.26; 95% confidence interval, 2.4-16.8; P

Original languageEnglish
Pages (from-to)2058-2065
JournalStroke
Volume47
Issue number8
DOIs
Publication statusPublished - 2016

    Research areas

  • angiography, permeability, reperfusion, stroke, thrombosis

ID: 9629106