Recanalization of cerebral arterial occlusion just before emergent conventional angiography

초록

Purpose : After development of stent retrieval system, mechanical thrombectomy is considered to the patients with hyperacute ischemic stroke caused by major cerebral artery occlusion with DWIPWI mismatch, which is usually identified on MR or CT scans. Sometimes, spontaneous recanalization is observed on emergent conventional angiography, which did not need further intervention. However, characteristics of recanalization in hyperacute period remained unknown. Here, we investigated the predictors for recanalization of cerebral arterial occlusion just before conventional angiography and outcomes of these cases. Methods : We reviewed hyperacute ischemic stroke patients who were admitted from July 2013 to August 2015 and took conventional angiography after identification of major arterial occlusion on MR or CT scans. We nalyzed the difference of risk factors, clinical characteristics and outcomes between the spontaneous recanalization group and the others. Results : A total of 104 subjects were enrolled (70 men, 69.0±10.6 years old). Among them, nine patients had recanalization on conventional angiography before neurointervention(9 men, 66.0±10.2 years old). pontaneous recanalization group was more frequently associated with men (p=0.02), embolic stroke tiology (p=0.05) and the history of diabetes mellitus(p 0.02), compared to nonrecanalizationgroup. Duration from stroke onset to MR or CT scan was much shorter in recanalization group than nonrecanalization group(63.1±21.2 vs 180.4±276.2 minutes, p<0.01). There was no difference in prevalence of hypertension, smoking, arterial occlusion site and intravenous rTPA therapy Conclusions : Our result suggests that spontaneous recanalization might occur within a few hours after stroke onset. This recanalization was associated with men, d