Journal article
Comparison of thrombectomy alone versus bridging thrombolysis in a US population using regression discontinuity analysis
Scientific reports, Vol.15(1), 18757
05/28/2025
DOI: 10.1038/s41598-025-03249-4
PMCID: PMC12120054
PMID: 40436992
Abstract
The role of intravenous thrombolysis (IVT) in combination with endovascular thrombectomy (EVT) for the treatment of large vessel occlusion acute ischemic stroke has been evaluated exclusively outside the US, in randomized clinical trials which failed to demonstrate non-inferiority of skipping IVT. Because practice patterns and IVT dosing differ within the US, and prior observational US-based cohorts suggested improved clinical outcomes in patients who received IVT before EVT, a US-based evaluation is needed. This is a quasi-experimental study of a large US cohort using a regression discontinuity design (RDD) that enables the estimation of causal effects when randomization is not feasible. In this multi-center prospective cohort of patients undergoing EVT, we observed a sharp drop (65%) in the probability of receiving IVT at the cutoff of IVT eligibility time window while there were no significant differences in potential confounders including age, NIHSS, and ASPECTS at the cutoff. We found no association between IVT treatment and functional independence (mRS 0-2) at 90-days in patients undergoing EVT, nor in the secondary outcomes of excellent outcomes (mRS 0-1) at 90 days, mortality, symptomatic intracranial hemorrhage, first pass reperfusion, or final reperfusion.
Details
- Title: Subtitle
- Comparison of thrombectomy alone versus bridging thrombolysis in a US population using regression discontinuity analysis
- Creators
- Youngran Kim - University of Texas Health Science Center at DallasSergio Salazar-Marioni - The University of Texas Health Science Center at HoustonRania Abdelkhaleq - The University of Texas Health Science Center at HoustonAnanya Iyyangar - The University of Texas Health Science Center at HoustonDiogo Haussen - Grady Memorial HospitalJonathan Grossberg - Grady Memorial HospitalJaydevsinh Dolia - Grady Memorial HospitalAqueel Pabaney - Grady Memorial HospitalMahmoud Mohammaden - Grady Memorial HospitalAmeer Hassan - Valley Baptist Medical CenterWondwossen Tekle - Valley Baptist Medical CenterHamzah Saei - Valley Baptist Medical CenterMohamad Abdalkader - Boston Medical CenterPiers Klein - Boston Medical CenterTaha Nisar - University of South AlabamaAdeel Saleemi - University of South AlabamaShahram Majidi - Icahn School of Medicine at Mount SinaiJohanna Fifi - Icahn School of Medicine at Mount SinaiGabrielle Valestin - Icahn School of Medicine at Mount SinaiGuillermo Linares - Saint Louis UniversityKara Christopher - Saint Louis UniversityDavid S Liebeskind - University of California, Los AngelesMouhammad Jumaa - ProMedica Toledo HospitalSyed Zaidi - ProMedica Toledo HospitalRaul Nogueira - Pittsburg State UniversityBrijesh Mehta - Memorial Neuroscience Institute, Hollywood, FL, USAJoy Sessa - Memorial Neuroscience Institute, Hollywood, FL, USAJuan Vivanco-Suarez - University of IowaAaron Rodriguez-Calienes - Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa City, IA, USAMilagros Galecio-Castillo - University of IowaSantiago Ortega-Gutierrez - University of IowaJames Siegler - Cooper Medical School of Rowan UniversityMary Penckofer - Cooper Medical School of Rowan UniversityItalo Linfante - The Cardiac and Vascular InstituteSunil A Sheth - The University of Texas Health Science Center at HoustonSVIN Registry Consortium
- Resource Type
- Journal article
- Publication Details
- Scientific reports, Vol.15(1), 18757
- DOI
- 10.1038/s41598-025-03249-4
- PMID
- 40436992
- PMCID
- PMC12120054
- NLM abbreviation
- Sci Rep
- ISSN
- 2045-2322
- eISSN
- 2045-2322
- Publisher
- NATURE PORTFOLIO
- Grant note
- R01NS121154 / NIH HHS
- Language
- English
- Date published
- 05/28/2025
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984824180902771
Metrics
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