Behrens L, Möhlenbruch M, Stampfl S, Ringleb P A, Hametner C, Kellert L, Pham M, Herweh C, Bendszus M, Rohde S
Department of Neuroradiology, Heidelberg University, Heidelberg, Germany.
Eur J Neurol. 2014 Nov;21(11):1406-10. doi: 10.1111/ene.12509. Epub 2014 Jul 21.
Thrombus length has been reported as an important predictor of successful recanalization by intravenous thrombolysis but its influence on bridging thrombolysis has not been investigated yet. The effect of thrombus length on recanalization rates evaluated by catheter angiography early after intravenous bridging thrombolysis was analyzed.
Ninety-six consecutive patients with acute cerebral artery occlusion were included. Occlusion site and thrombus length on initial computed tomography angiography or magnetic resonance angiography were related to recanalization after intravenous bridging thrombolysis on the initial series of catheter angiography.
Eleven of 96 patients (11.5%) showed successful recanalization (TICI 2a, 2b or 3) after intravenous bridging thrombolysis. Mean thrombus length in these patients was 10.8 mm as opposed to 15.6 mm in patients without successful recanalization. No thrombus longer than 16 mm showed complete recanalization. Binary logistic regression demonstrated a significant influence of thrombus length on probability of recanalization (odds ratio 0.78, 95% confidence interval 0.65-0.95; P = 0.014).
Thrombus length is a significant predictor of recanalization rates after bridging thrombolysis. Overall recanalization rate within the time frame until interventional treatment is started was 11.5% after bridging thrombolysis.
已有报道称血栓长度是静脉溶栓成功再通的重要预测指标，但尚未研究其对桥接溶栓的影响。分析了静脉桥接溶栓后早期通过导管血管造影评估的血栓长度对再通率的影响。
纳入96例连续的急性脑动脉闭塞患者。初始计算机断层血管造影或磁共振血管造影上的闭塞部位和血栓长度与初始系列导管血管造影上静脉桥接溶栓后的再通情况相关。
96例患者中有11例（11.5%）在静脉桥接溶栓后显示成功再通（脑梗死溶栓分级2a、2b或3级）。这些患者的平均血栓长度为10.8mm，而未成功再通的患者为15.6mm。没有血栓长度超过16mm的患者实现完全再通。二元逻辑回归显示血栓长度对再通概率有显著影响（优势比0.78，95%置信区间0.65 - 0.95；P = 0.014）。
血栓长度是桥接溶栓后再通率的重要预测指标。在开始介入治疗前的时间范围内，桥接溶栓后的总体再通率为11.5%。
