据12月一期的《卒中》(Stroke)报告，卒中后采用动脉内溶栓疗法(intra-arterial thrombolysis ,IAT)，其效益至少可长达2年。
Intra-Arterial Thrombolysis Provides Long-Term Benefit After Stroke
The benefit of intra-arterial thrombolysis (IAT) after stroke is sustained for at least 2 years, according to a report in the December issue of Stroke.
"IAT is a treatment we can offer to our patients," Dr. Heinrich P. Mattle from University of Bern, Switzerland told Reuters Health, "and patients generally benefit from IAT when the time window for treatment with intravenous thrombolysis using rtPA has already elapsed."
Dr. Mattle and colleagues compared 2-year outcomes of 144 stroke patients treated with IAT with those of 147 matching patients treated with aspirin within the first 24 hours after symptom onset.
Forty percent of patients treated with IAT had excellent outcomes 24 months after their strokes, the authors report, and 56% remained functionally independent.
By comparison, 24% of aspirin patients had an excellent outcome at 24 months, and 42% were functionally independent.
Mortality at 2 years was similar in the two groups, the researchers note, at 23% in the IAT group and 24% in the aspirin group.
A high NIH Stroke Scale score independently predicted adverse outcomes in both groups, the report indicates. Hypertension predicted adverse outcomes in the aspirin group and advancing age predicted adverse outcomes in the IAT group.
"The long-term outcome in stroke patients treated with IAT is comparable to that of patients treated in the NINDS rtPA study and observational intravenous thrombolysis trials," the investigators write.
"The open question is which patient should receive intravenous and which patient should receive IAT," Dr. Mattle said. "To answer this question randomized trials comparing intravenous thrombolysis and IAT will be needed."