Association of occlusion site with clinical outcome in acute ischemic stroke patients treated with intravenous thrombolytics

Objectives: Intravenous thrombolytic treatment, when administered in the first 4.5 hours of stroke, is an approved treatment for acute ischemic stroke. Here, we intend to study the efficiency of intravenous thrombolytic treatment in acute ischemic stroke according to the vascular occlusion site. Methods: Acute ischemic stroke patients who admitted to our hospital between 01.10.2013-01.10.2015 and treated with intravenous thrombolytics were retrospectively reviewed. Sociodemographical and clinical characteristics, elapsed time until to treatment, NIHSS scores at admission, after 1 hour and 24 hour after treatment were recorded. Modified Rankin scores at 3rd month were calculated according to the clinical follow-up. Sociodemigraphics, NIHSS and ASPECTS and modified Rankin scores were compared between patients with no occlusion or MCA M1 distal, M2 andM3 occlusions and patients with ICA T occlusions or MCA M1 proximal occlusions. Results: There were 74 acute ischemic stroke patients with vascular imagings and treated with intravenous thrombolytics. 37 patients had no occlusion, 9 had ICA T occlusion, 17 had MCA M1 oclusion, of these 13 had M1 distal and 4 had 10 had M1 proximal occlusiın. 10 patients had MCA M2 or M3 occlusion. Basillary artery occlusion was seen only in 1 patient. The patients were divided into two grous according to occlusion site: no occlusion, MCA M1 distal, M2 andM3 occlusions and ICA T oklusions MCA M1 proximal occlusions. 1 st and 24th hour NIHSS scores and 3. month modified Rankin scores were lower in the former group and there was statistically significancy. Also, in logistic regression analysis, occlusion site was an independent factor in determining 1 st and 24th hour NIHSS s and 3rd month modified Rankin scores. Conclusions: Intravenous thrombolytic treatment is an approved and efficient treatment in acute ischemic stroke. Nevertheless, clinical and functional outcome is lower in patients with proximal arterial occlusion than the patients with no or distal occlusion