Early stroke treatment with IV t-PA associated with early recanalization

Purpose: Time from stroke onset to treatment (OTT) is potentially an important factor affecting subsequent outcome in patients treated with t-PA. The aim of the study was to assess the correlation between OTT and early recanalization rate after IV-t-PA therapy. Methods: Consecutive stroke patients treated with t-PA within 3 h of onset were prospectively studied. Patients with major brain artery occlusion on MRA before t-PA infusion were enrolled. The correlation between OTT and the early recanalization rate within 1 h after t-PA infusion was determined. Results: 102 patients (M1 occlusion, 41 patients; M2, 19; ICA, 31; BA, 8; and PCA, 3) were enrolled. Follow-up MRA within 1 h after t-PA infusion showed early recanalization in 42(41.2%) patients (complete in 13 patients, partial in 29). The early recanalization rate was 53.8% with OTT <= 100 min, 57.1% in 101-110 min, 50.0% in 111-120 min, 63.6% in 121-130 min, 33.3% in 131-140 min, 30.0% in 141-150 min, 36.4% in 151-160 min, 18.2% in 161-170 min, and 32.0% in 171-180 min. OTT was negatively correlated with the early recanalization rate (r = -0.767, P = 0.0301). After adjusting the presence of age (>74), ICA occlusion, baseline NIHSS score (<10), and glucose (>150 mg/dl), adjusted OR for early recanalization of OTT <= 130 min against OTT > 130-180 min was 2.97 (95% CI 1.27-6.96, P = 0.012). Conclusion: Early recanalization depended on time from stroke onset to IV-t-PA administration. Thus, t-PA should be given to acute stroke patients as soon as possible. (C) 2010 Elsevier B.V. All rights reserved.