Outcome of intravenous thrombolysis in acute ischemic stroke patients with small vessel disease

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2024-10-01 DOI:10.1016/j.clineuro.2024.108570

Alshaimaa M. Aboulfotooh, Haytham Rizk, Omar El Serafy, Sandra M. Ahmed, Nourhan M. Soliman

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引用次数: 0

Abstract

Introduction

Lacunar stroke (LS) subtype accounts for a quarter of ischemic strokes. Intravenous thrombolysis (IVT) is known to improve overall stroke outcomes. Very few studies have focused on the outcome of IVT in lacunar strokes. Aim: To detect the outcome of IVT in LS patients compared to non-thrombolysed LS patients.

Methods

Fifty patients presenting with LS received the standard protocol of IVT (Group I). They were compared to fifty matched LS patients who presented beyond the time window and were selected as the control group (Group II). Clinical outcome was measured using NIHSS within 24 h, NIHSS at discharge, and MRS after 3 months. Risk factors that could have affected clinical outcomes were compared in the thrombolysis group.

Results

The short-term clinical outcome of Group I showed statistically significant improvement of NIHSS after 24 hrs compared to Group II (mean NIHSS = 5.52±3.89 and 7.44±1.82 respectively), as well as on discharge (mean NIHSS = 3.88±3.50 and 5.78±2.97) respectively. For long-term outcomes, 94 % of GroupⅠ reached MRS 0, 1, and 2 (n = 47/50) versus 74 % (n = 36/50) in Group II. Longer door-to-needle time, severe WMCs (Fazekas score), and pneumonia were shown to be significant predictor factors for the worst outcome.

Conclusion

IVT has improved short- and long-term outcomes in LS patients. Longer door-to-needle time, severe WMCs, and pneumonia were shown to be significant predictor factors for the worst outcome.

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对患有小血管疾病的急性缺血性脑卒中患者进行静脉溶栓治疗的结果。

简介腔隙性中风（LS）亚型占缺血性中风的四分之一。众所周知，静脉溶栓（IVT）可改善中风的总体预后。目的：与非溶栓治疗的 LS 患者相比，检测 IVT 对 LS 患者的治疗效果：50名LS患者接受了IVT标准方案（I组）。将这些患者与超过时间窗且被选为对照组（II 组）的 50 名匹配的 LS 患者进行比较。临床结果通过 24 小时内的 NIHSS、出院时的 NIHSS 和 3 个月后的 MRS 进行测量。比较了溶栓组中可能影响临床结果的风险因素：第一组的短期临床结果显示，与第二组相比，24 小时后 NIHSS（平均值分别为 5.52±3.89 和 7.44±1.82）以及出院时 NIHSS（平均值分别为 3.88±3.50 和 5.78±2.97）均有显著改善。就长期结果而言，Ⅰ组有94%的患者达到MRS 0、1和2（n = 47/50），而Ⅱ组为74%（n = 36/50）。结果表明，较长的进针时间、严重的WMC（Fazekas评分）和肺炎是预测最坏结果的重要因素：IVT改善了LS患者的短期和长期预后。结论：IVT 可改善 LS 患者的短期和长期预后，而较长的门到针时间、严重的 WMCs 和肺炎则是预测最差预后的重要因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.