Ju H Lee

Hallym University, Seoul, Seoul, South Korea

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Publications (2)10.4 Total impact

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    ABSTRACT: Factors affecting the angiographic recanalization (AR) and clinical improvement (CI) still remain unclear in patients receiving thrombolytic therapy. To elucidate factors related to AR and early CI in patients with middle cerebral artery (MCA) or internal carotid artery (ICA) occlusion. Retrospective study. Department of Neurology, Asan Medical Center, Seoul, South Korea. We studied 42 patients who (1) underwent diffusion-weighted magnetic resonance (MR) imaging and MR angiography within 6 hours after onset, (2) had MCA territory infarction, (3) had nonvisualization of the MCA or the ICA on initial MR angiography, (4) were treated with thrombolytics, and (5) underwent follow-up MR imaging and MR angiography at day 2 or 3. Successful AR and CI were achieved in 31 and 16 patients, respectively. Angiographic recanalization was related to CI (P<.01), lower follow-up National Institutes of Health Stroke Scale scores (P<.05), the absence of a dominant ipsilateral posterior cerebral artery (P<.01) on initial MR angiography, and the sparing of the internal capsule on both initial (P<.05) and follow-up (P<.01) MR imaging. Clinical improvement was associated with the absence of ICA (vs MCA) flow signals (P<.05), the sparing of the internal capsule (P<.01), and marginally, with the infarct volume change (P = .06). In patients with MCA or ICA occlusion, CI after thrombolysis is related to the AR and the sparing of the critical motor pathway. The presence of a dominant ipsilateral posterior cerebral artery may predict poor AR after thrombolysis.
    JAMA Neurology 12/2004; 61(11):1682-6. · 7.58 Impact Factor
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    ABSTRACT: Although percutaneous transluminal angioplasty (PTA) is an effective treatment modality in the coronary and peripheral arterial diseases, its efficacy for intracranial atherosclerotic stenosis has not been verified. We assessed the long-term outcome of PTA for symptomatic middle cerebral artery (MCA) stenosis. We performed PTA in 10 patients with symptomatic high-grade stenosis (>70%) on M1 segment of MCA, who had either recurrent transient ischemic attacks (TIAs) resistant to medical therapy or perfusion problems. PTA was performed with a microballoon (2-2.5 mm diameter and 10-13 mm length) without insertion of a stent. After PTA, we evaluated the possible occurrence of restenosis, which was defined as >50% stenosis on follow-up conventional angiogram or increased M1 flow velocity on follow-up transcranial doppler up to the baseline value. PTA was successfully performed in 9 patients without any serious complications. One patient had asymptomatic dissection. Residual stenosis was less than 50% in diameter in all the patients. During follow-up period (mean 34.5 months), TIAs did not recur in 6 of 7 patients who had had intractable TIAs. Two patients developed strokes, which were not referable to the index MCA lesions. Among the 6 patients who underwent follow-up conventional angiography or serial TCD, restenosis was noticed in 3 patients (50%). Although restenosis is not uncommon, PTA for symptomatic MCA stenosis is a relatively safe procedure, and can be used to prevent recurrent TIAs or strokes in selected patients.
    Cerebrovascular Diseases 01/2003; 15(1-2):90-7. · 2.81 Impact Factor