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J Korean Soc Radiol. 2015 Oct;73(4):230-239. English. Original Article. https://doi.org/10.3348/jksr.2015.73.4.230
Jung S , Jung C , Kim JH , Choi BS , Kim BJ , Han MK , Bae HJ , Kwon BJ , Cha SH .
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea. jck0097@gmail.com
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Radiology, Myongji Hospital, Goyang, Korea.
Department of Radiology, Chungbuk National University College of Medicine, Daejeon, Korea.
Abstract

PURPOSE: There is little data on the effect of intra-arterial therapy (IAT) in acute cardioembolic internal carotid artery terminus (ICAT) occlusion that has poor prognosis. We determined procedural and clinical outcomes in patients with acute cardioembolic ICAT occlusion treated with different methods of IAT. MATERIALS AND METHODS: On retrospective review of our registry, patients with cardioembolic ICAT occlusion were categorized as thrombolytic-based IAT group (TLG) and thrombectomy-based IAT group (TEG) according to the primary endovascular technique. Subsequently, procedural and clinical outcomes were compared. RESULTS: Fifty-five patients had cardioembolic ICAT occlusion and 18 patients were assigned to TLG and 37 patients to TEG. The rate of complete reperfusion was significantly higher and the groin puncture to reperfusion time was significantly shorter in TEG than those in TLG. There was a trend towards functional outcome at 3 months in the TEG group; however, it was not statistically significant (p = 0.06). Age, baseline Albert Stroke program early CT score and puncture to reperfusion time were factors affecting unfavorable outcome at 3 months, on multivariable analysis. CONCLUSION: Thrombectomy-based IAT has advantages over thrombolytic-based IAT in terms of the reduction of groin puncture to reperfusion time and improvement of the rate of complete reperfusion.

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