Table 1. Previous reports of intravenous recombinant tissue plasminogen activator therapy for branch atheromatous disease§ .
| First author, year | Study design | Perforating branch infarct location | Initial treatment, number of cases | Post-therapy |
END§§, n (%) |
mRS ≤ 1 at 3 months, n (%) | sICH |
|---|---|---|---|---|---|---|---|
| Deguchi I, 2013 9) | Retrospective | LSA | rt-PA group only (0.6 mg/kg), n=8 |
5 patients received argatroban, 6 received clopidogrel/aspirin, 4 received cilostazol |
No definition | 4 (50 %) | 1 (13%) |
| Park MG, 2016 18) | Retrospective | LSA | rt-PA group (0.9 mg/kg), n=9 | 75 mg of clopidogrel once daily | 6 (66.7%) | 2 (20%) | 0 |
| non-rt-PA group (300 mg of clopidogrel), n=26 | 75 mg of clopidogrel once daily | 18 (69.2%) | 7 (29.6%) | 0 | |||
| Wu X, 2020 19) | Retrospective (propensity score matching) | LSA, PPA | rt-PA group (0.9 mg/kg), n=42 | 75 mg of clopidogrel and 100 mg of aspirin once daily | 5 (11.9%) | 28 (66.7%) | 2 (5%) |
| control group (300 mg of clopidogrel and 100 mg of aspirin), n=42 | 75 mg of clopidogrel and 100 mg of aspirin once daily | 13 (31.0%) | 14 (33.3%) | 0 |
Abbreviations: END, early neurological deterioration; LSA, lenticulostriate artery; mRS, modified Rankin Scale; PPA, paramedian pontine artery; rt-PA, recombinant tissue-type plasminogen activator; sICH, Symptomatic intracranial hemorrhage
§Definitions of branch atheromatous disease
Deguchi I: Infarction involving ≥ 3 axial slices on diffusion-weighted imaging (DWI) in the lenticulostriate artery (LSA); and no stenosis (≥ 50%) or occlusion of a major artery of the branch artery and no cardioembolic source (e.g., atrial fibrillation) on magnetic resonance angiography
Park MG: Infarction involving ≥ 3 axial slices on DWI in the LSA territory; no evidences of large artery disease (＞50% stenosis of relevant artery) and cardioembolism according to the classification of the Trial of Org 10172 in Acute Stroke Treatment (TOAST)
Wu X: Infarcts with a diameter ≥ 15 mm that involves ≥ 3 axial slices on DWI in the LSA territory, or lesions extending to the ventral pontine surface in the paramedian pontine artery; neither evidence of large arterial stenosis (＞50%) or occlusion, nor evidence of cardiogenic embolism
§§Definition of END
Park MG: END was defined as an increase of ≥ 1 point in motor power or an increase of ≥ 2 points in the total National Institutes of Health Stroke Scale (NIHSS) score within 7 days after stroke.
Wu X: END was defined as an increase of ≥ 2 points in the NIHSS score within 7 days after stroke.