MR Imaging−Based Localized Intra-Arterial Thrombolysis Assisted by Mechanical Clot Disruption for Acute Ischemic Stroke due to Middle Cerebral Artery Occlusion

Article Figures & Data

Table 1:

Univariate statistics of background and intracranial hemorrhage for patients with poor clinical outcome and favorable outcome

	Clinical Outcome at 90 days		P
	Poor (mRS, 3–6)	Favorable (mRS, 0–2)	P
No. of patients	42	48
Age (yr, mean)	74.4 ± 8.9	72.3 ± 11.6	.313^{^b}
Sex (male)	28 (67%)	30 (63%)	.680^{^c}
OTP time^{^a} (min, mean)	209.2 ± 75.2	201.7 ± 50.2	.575^{^b}
Hypertension	25 (60%)	26 (54%)	.609^{^c}
Diabetes mellitus	11 (26%)	11 (23%)	.718^{^c}
Hyperlipidemia	7 (17%)	10 (21%)	.614^{^c}
Coronary disease	10 (24%)	8 (17%)	.398^{^c}
Peripheral arterial stenotic diseases	3 (7%)	2 (4%)	.661^{^d}
Previous stroke	11 (26%)	6 (13%)	.098^{^c}
Side of lesion (left)	30 (71%)	27 (56%)	.136^{^c}
B-NIHSS^{^e} (points, median)	20 (9–26)	14.5 (7–24)	.001^{^f}
No. of patients with high score of B-NIHSS (≥20 points)	24 (57%)	13 (27%)	.004^{^c}
Stroke etiology: cardiogenic embolism	32 (76%)	37 (77%)	.920^{^c}
ASPECTS on MRI (points, median)	7 (5–10)	8 (5–10)	<.001^{^f}
No. of patients with low ASPECTS (5–7)	27 (64%)	8 (17%)	<.001^{^c}
Administration of free radical scavenger	31 (74%)	33 (69%)	.597^{^c}
Symptomatic ICH within 24 hours	6 (14%)	1 (2%)	.047^{^d}
All ICH within 24 hours	17 (40%)	10 (21%)	.042^{^c}

Table 2:

Univariate statistics of angiographic results and methods of LIT-MCD for patients with poor clinical outcome and favorable outcome

	Clinical Outcome at 90 Days		P
	Poor (mRS, 3–6)	Favorable (mRS, 0–2)	P
No. of patients	42	48
Location of occlusion
Proximal M1^{^a}	17 (41%)	3 (6%)	<.001^{^b}
Distal M1	12 (29%)	17 (35%)	.488^{^b}
M2^{^c}	13 (31%)	28 (58%)	.009^{^b}
No. of patients with
Preprocedural TICI of grade 0	38 (90%)	37 (77%)	.089^{^b}
Poor collaterals (CFGS, grade 1)	6 (14%)	2 (4%)	.139^{^d}
Moderate collaterals (grade 2)	35 (83%)	41 (85%)	.786^{^b}
Ample collaterals (grade 3)	1 (2%)	5 (10%)	.209^{^d}
Dose of urokinase (×10³ U) (mean)	237 ± 9.1	265 ± 10.0	.172^{^e}
Use of low dose of urokinase (≤240,000 U)	37 (88%)	33 (69%)	.028^{^b}
Use of mechanical clot disruption	37 (88%)	25 (52%)	<.001^{^b}
No recanalization (TICI grade 0 + 1)	15 (36%)	2 (4%)	<.001^{^b}
Postprocedural TICI grade
0	12 (29%)	1 (2%)	<.001^{^b}
1	3 (7%)	1 (2%)	.336^{^d}
2a	18 (43%)	19 (40%)	.753^{^b}
2b	7 (17%)	16 (33%)	.071^{^b}
3	2 (5%)	11 (23%)	.015^{^b}
Procedure-related complications	5 (12%)	4 (8%)	.729^{^d}

a Indicates occlusion of the horizontal segment (M1) of the MCA at or proximal to the lenticulostriate arteries.
b χ² test.
c Insular segment of the MCA.
d Fisher exact test.
e Unpaired t test.

Table 3:

Multivariable ORs and 95% CIs for predictive factors of poor clinical outcome

Variable	OR	95% CI	P
High score of baseline NIHSS (≥20)	4.67	1.44–15.12	.01
Low preprocedural ASPECTS (≤7)	5.8	1.81–18.64	.003
Proximal M1 occlusion^{^a}	8.78	1.83–42.24	.007
No recanalization (TICI 0–1)	15.41	2.54–93.48	.003