Emergent loading dose of antiplatelets for stenting after IV rt-PA in acute ischemic stroke: a feasibility study

被引：3

作者：

Han, Yun-Fei ^{[1
]}

Dai, Qi-Liang ^{[1
]}

Chen, Xiang-Liang ^{[1
]}

Xiong, Yun-Yun ^{[1
]}

Yin, Qin ^{[1
]}

Xu, Ge-Lin ^{[1
]}

Zhu, Wu-Sheng ^{[1
]}

Zhang, Ren-Liang ^{[1
]}

Ma, Min-Min ^{[1
]}

Liu, Wen-Hua ^{[1
,2
]}

Liu, Xin-Feng ^{[1
]}

机构：

[1] Nanjing Univ, Jinling Hosp, Dept Neurol, Sch Med, Nanjing, Jiangsu, Peoples R China

[2] Wuhan 1 Hosp, Dept Neurol, Wuhan, Hubei, Peoples R China

来源：

INTERNATIONAL JOURNAL OF NEUROSCIENCE | 2018年 / 128卷 / 04期

基金：

中国国家自然科学基金;

关键词：

Hemorrhagic transformation; collateral; HAT score; emergent stenting; antiplatelet; TISSUE-PLASMINOGEN ACTIVATOR; RANDOMIZED CONTROLLED-TRIAL; INTRAVENOUS T-PA; ENDOVASCULAR TREATMENT; HEMORRHAGIC TRANSFORMATION; THERAPY; THROMBOLYSIS; RECANALIZATION; THROMBECTOMY; OCCLUSIONS;

D O I：

10.1080/00207454.2017.1367295

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Background: A loading dose of antiplatelets reduces in-stent thrombosis after stent implantation. However, whether it is safe in patients undergoing acute stenting after intravenous recombinant tissue plasminogen activator (rt-PA) is unclear.Methods: A case series of acute ischemic stroke patients treated with intravenous rt-PA followed by emergent stenting were prospectively included in Jinling Hospital Stroke Unit. An emergent loading dose of antiplatelets (aspirin 300mg and clopidogrel 300 mg) were administered to all patients through a nasogastric tube immediately before stenting. Clinical and angiographic outcomes were evaluated in these patients.Results: A total of 12 patients were included. The median of NIHSS score on admission was 15 points (interquartile range 11-19). The median of time from stroke symptom onset to start IV rt-PA and stent placement was 172min (interquartile range 123.75-189) and 311.5min (interquartile range 285.5-349.5), respectively. All patients reached complete or partial recanalization (TICI 2a). One patient occurred hemorrhagic transformation at 24h following the emergent loading dose of antiplatelets. A favorable outcome as defined by mRS 2 at 90days was obtained in 58.3% (7/12) of all patients.Conclusion: Our finding preliminary suggested that an emergent loading dose of antiplatelets may be safe and feasible for acute stenting after IV rt-PA.

引用

页码：311 / 317

页数：7

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