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<meta name="DC.Title" content="Revascularization Results in the Interventional Management of Stroke II Trial" />
<meta name="DC.Identifier" content="10.3174/ajnr.A0843" />
<meta name="DC.Date" content="2008-03-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Our aim was to detail revascularization results, including impact on outcome and mortality, in the Interventional Management of Stroke (IMS) II trial.

MATERIALS AND METHODS: IMS II was designed to obtain estimates of the efficacy and safety of reduced-dose intravenous recombinant tissue plasminogen activator (rtPA) followed by additional intra-arterial rtPA and low-energy sonography via the EKOS Primo Micro-Infusion Catheter at the occlusion in selected patients with ischemic stroke treated within 3 hours of onset. Revascularization outcomes were detailed and compared with modified Rankin Scale scores 0–2, mortality outcomes, and results from IMS I.

RESULTS: Complete recanalization at 60 minutes occurred in 12 of 29 (41.4%) sonography microcatheter–treated occlusions. Complete recanalization was achieved at 2 hours or procedure end in 20/29 (68.9%) in the ultrasound catheter–treated group, and final thrombolysis in cerebral infarction (TICI) 2/3 reperfusion was achieved in 18/29 (62.0%) ultrasound-treated subjects. Fifteen-minute angiograms demonstrated some recanalization in 69/145 (46.7%) sonography microcatheter treatment intervals, compared with 39/111 (35.1%) in IMS I treatments in 23 subjects with reliable 15-minute angiograms ( P = .046). Pooled IMS I-II data demonstrated that partial or complete recanalization occurred in 56/75 (74.6%) and good reperfusion (TICI 2/3) occurred in 46/75 (61.3%) of internal carotid artery T and M1 occlusions. Revascularization correlated with good outcome for TICI 2/3 reperfusion ( P = .0004), TICI 2B/3 reperfusion ( P = .0002), and arterial occlusive lesion 2/3 recanalization ( P = .03).

CONCLUSION: IMS II provides evidence that the EKOS Primo sonography microcatheter exhibits a trend toward improved recanalization of the occlusion compared with a standard microcatheter and again confirms the correlation between recanalization and reperfusion with good clinical outcome and reduced mortality." />
<meta name="DC.Contributor" content="T. Tomsick" />
<meta name="DC.Contributor" content="J. Broderick" />
<meta name="DC.Contributor" content="J. Carrozella" />
<meta name="DC.Contributor" content="P. Khatri" />
<meta name="DC.Contributor" content="M. Hill" />
<meta name="DC.Contributor" content="Y. Palesch" />
<meta name="DC.Contributor" content="J. Khoury" />
<meta name="DC.Contributor" content="for the Interventional Management of Stroke II Investigators" />
<meta name="article:published_time" content="2008-03-01" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="Revascularization Results in the Interventional Management of Stroke II Trial" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; Our aim was to detail revascularization results, including impact on outcome and mortality, in the Interventional Management of Stroke (IMS) II trial.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; IMS II was designed to obtain estimates of the efficacy and safety of reduced-dose intravenous recombinant tissue plasminogen activator (rtPA) followed by additional intra-arterial rtPA and low-energy sonography via the EKOS Primo Micro-Infusion Catheter at the occlusion in selected patients with ischemic stroke treated within 3 hours of onset. Revascularization outcomes were detailed and compared with modified Rankin Scale scores 0–2, mortality outcomes, and results from IMS I.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; Complete recanalization at 60 minutes occurred in 12 of 29 (41.4%) sonography microcatheter–treated occlusions. Complete recanalization was achieved at 2 hours or procedure end in 20/29 (68.9%) in the ultrasound catheter–treated group, and final thrombolysis in cerebral infarction (TICI) 2/3 reperfusion was achieved in 18/29 (62.0%) ultrasound-treated subjects. Fifteen-minute angiograms demonstrated some recanalization in 69/145 (46.7%) sonography microcatheter treatment intervals, compared with 39/111 (35.1%) in IMS I treatments in 23 subjects with reliable 15-minute angiograms (&lt;i&gt;P&lt;/i&gt; = .046). Pooled IMS I-II data demonstrated that partial or complete recanalization occurred in 56/75 (74.6%) and good reperfusion (TICI 2/3) occurred in 46/75 (61.3%) of internal carotid artery T and M1 occlusions. Revascularization correlated with good outcome for TICI 2/3 reperfusion (&lt;i&gt;P&lt;/i&gt; = .0004), TICI 2B/3 reperfusion (&lt;i&gt;P&lt;/i&gt; = .0002), and arterial occlusive lesion 2/3 recanalization (&lt;i&gt;P&lt;/i&gt; = .03).&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSION:&lt;/b&gt; IMS II provides evidence that the EKOS Primo sonography microcatheter exhibits a trend toward improved recanalization of the occlusion compared with a standard microcatheter and again confirms the correlation between recanalization and reperfusion with good clinical outcome and reduced mortality.&lt;/p&gt;" />
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<meta name="citation_reference" content="citation_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_title=Safety of Mechanical Thrombectomy and Intravenous Tissue Plasminogen Activator in Acute Ischemic Stroke. Results of the Multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI) Trial, Part I;citation_pages=1177-1182;citation_volume=27;citation_year=2006;citation_issue=6;citation_issn=0195-6108;citation_pmid=16775259" />
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<meta name="citation_reference" content="citation_title=Stroke;citation_pages=454;citation_volume=38;citation_year=2007;citation_issn=0039-2499" />
<meta name="twitter:title" content="Revascularization Results in the Interventional Management of Stroke II Trial" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Our aim was to detail revascularization results, including impact on outcome and mortality, in the Interventional Management of Stroke (IMS) II trial.

MATERIALS AND METHODS: IMS II was designed to obtain estimates of the efficacy and safety of reduced-dose intravenous recombinant tissue plasminogen activator (rtPA) followed by additional intra-arterial rtPA and low-energy sonography via the EKOS Primo Micro-Infusion Catheter at the occlusion in selected patients with ischemic stroke treated within 3 hours of onset. Revascularization outcomes were detailed and compared with modified Rankin Scale scores 0–2, mortality outcomes, and results from IMS I.

RESULTS: Complete recanalization at 60 minutes occurred in 12 of 29 (41.4%) sonography microcatheter–treated occlusions. Complete recanalization was achieved at 2 hours or procedure end in 20/29 (68.9%) in the ultrasound catheter–treated group, and final thrombolysis in cerebral infarction (TICI) 2/3 reperfusion was achieved in 18/29 (62.0%) ultrasound-treated subjects. Fifteen-minute angiograms demonstrated some recanalization in 69/145 (46.7%) sonography microcatheter treatment intervals, compared with 39/111 (35.1%) in IMS I treatments in 23 subjects with reliable 15-minute angiograms ( P = .046). Pooled IMS I-II data demonstrated that partial or complete recanalization occurred in 56/75 (74.6%) and good reperfusion (TICI 2/3) occurred in 46/75 (61.3%) of internal carotid artery T and M1 occlusions. Revascularization correlated with good outcome for TICI 2/3 reperfusion ( P = .0004), TICI 2B/3 reperfusion ( P = .0002), and arterial occlusive lesion 2/3 recanalization ( P = .03).

CONCLUSION: IMS II provides evidence that the EKOS Primo sonography microcatheter exhibits a trend toward improved recanalization of the occlusion compared with a standard microcatheter and again confirms the correlation between recanalization and reperfusion with good clinical outcome and reduced mortality." />
<meta name="og-title" property="og:title" content="Revascularization Results in the Interventional Management of Stroke II Trial" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/29/3/582" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Our aim was to detail revascularization results, including impact on outcome and mortality, in the Interventional Management of Stroke (IMS) II trial.

MATERIALS AND METHODS: IMS II was designed to obtain estimates of the efficacy and safety of reduced-dose intravenous recombinant tissue plasminogen activator (rtPA) followed by additional intra-arterial rtPA and low-energy sonography via the EKOS Primo Micro-Infusion Catheter at the occlusion in selected patients with ischemic stroke treated within 3 hours of onset. Revascularization outcomes were detailed and compared with modified Rankin Scale scores 0–2, mortality outcomes, and results from IMS I.

RESULTS: Complete recanalization at 60 minutes occurred in 12 of 29 (41.4%) sonography microcatheter–treated occlusions. Complete recanalization was achieved at 2 hours or procedure end in 20/29 (68.9%) in the ultrasound catheter–treated group, and final thrombolysis in cerebral infarction (TICI) 2/3 reperfusion was achieved in 18/29 (62.0%) ultrasound-treated subjects. Fifteen-minute angiograms demonstrated some recanalization in 69/145 (46.7%) sonography microcatheter treatment intervals, compared with 39/111 (35.1%) in IMS I treatments in 23 subjects with reliable 15-minute angiograms ( P = .046). Pooled IMS I-II data demonstrated that partial or complete recanalization occurred in 56/75 (74.6%) and good reperfusion (TICI 2/3) occurred in 46/75 (61.3%) of internal carotid artery T and M1 occlusions. Revascularization correlated with good outcome for TICI 2/3 reperfusion ( P = .0004), TICI 2B/3 reperfusion ( P = .0002), and arterial occlusive lesion 2/3 recanalization ( P = .03).

CONCLUSION: IMS II provides evidence that the EKOS Primo sonography microcatheter exhibits a trend toward improved recanalization of the occlusion compared with a standard microcatheter and again confirms the correlation between recanalization and reperfusion with good clinical outcome and reduced mortality." />
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2008,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">582-587; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A0843 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-7931--61983430448" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">T. Tomsick </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BTomsick%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tomsick%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.%2BTomsick%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J. 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Khatri </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BKhatri%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Khatri%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AP.%2BKhatri%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 29</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 3 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">March 2008 </div></div>
      
      
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      <div class="highwire-cite-title">Revascularization Results in the Interventional Management of Stroke II Trial</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Tomsick</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Broderick</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Carrozella</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Khatri</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Hill</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Palesch</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Khoury</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2008, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">582-587; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0843 </span></div>
  
  
  
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      <div class="highwire-cite-title">Revascularization Results in the Interventional Management of Stroke II Trial</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Tomsick</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Broderick</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Carrozella</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Khatri</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Hill</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Palesch</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Khoury</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2008, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">582-587; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0843 </span></div>
  
  
  
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