G11-3 The significance of carotid echography in decision making for IV t-PA therapy

We investigated the significance of carotid echography in decision making for IV t-PA therapy on acute ischemic stroke patients. Among 88 consecutive cases of acute ischemic stroke patients who were admitted within 3 hours of onset, time that elapsed from onset to the end of the echography and time that was needed to complete the echography were evaluated. We investigated findings of the echography that influenced decision making for IV t-PA. Carotid echography was completed within 3 hours of onset (116+/-32 minutes) on all 54 cases on whom we started the examinations within 3 hours. Time required to complete the examination was 6.5 minutes (median) for each patient. Of these, 16 cases were administered IV t-PA. The carotid echography revealed 6 cases with occlusion of internal carotid artery and 1 case with extension of thoracic aortic dissection to common carotid artery. These 7 cases were excluded from IV t-PA after all. We administered IV t-PA on 5 cases of 34 cases who were not examined with carotid echography within 3 hours. Of these, one case was diagnosed afterwards as being complicated with thoracic aortic dissection resulting in fatal outcome. The findings of carotid echography were useful for decision making in IV t-PA therapy.