Journal article
Effect of intravenous thrombolysis before endovascular therapy on outcomes in patients with large core infarct
Journal of neurointerventional surgery, Vol.15(e3), pp.e414-e418
12/2023
DOI: 10.1136/jnis-2022-019537
PMID: 36990690
Abstract
BackgroundThe safety and efficacy of bridging therapy with intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) in patients with large core infarct has not been sufficiently studied. In this study, we compared the efficacy and safety outcomes between patients who received IVT+MT and those treated with MT alone.MethodsThis is a retrospective analysis of the Stroke Thrombectomy Aneurysm Registry (STAR). Patients with Alberta Stroke Program Early CT Score (ASPECTS) ≤5 treated with MT were included in this study. Patients were divided into two groups based on pre-treatment IVT (IVT, no IVT). Propensity score matched analysis were used to compare outcomes between groups.ResultsA total of 398 patients were included; 113 pairs were generated using propensity score matching analyses. Baseline characteristics were well balanced in the matched cohort. The rate of any intracerebral hemorrhage (ICH) was similar between groups in both the full cohort (41.4% vs 42.3%, P=0.85) and matched cohort (38.55% vs 42.1%, P=0.593). Similarly, the rate of significant ICH was similar between the groups (full cohort: 13.1% vs 16.9%, P=0.306; matched cohort: 15.6% vs 18.95, P=0.52). There was no difference in favorable outcome (90-day modified Rankin Scale 0–2) or successful reperfusion between groups. In an adjusted analysis, IVT was not associated with any of the outcomes.ConclusionPretreatment IVT was not associated with an increased risk of hemorrhage in patients with large core infarct treated with MT. Future studies are needed to assess the safety and efficacy of bridging therapy in patients with large core infarct.
Details
- Title: Subtitle
- Effect of intravenous thrombolysis before endovascular therapy on outcomes in patients with large core infarct
- Creators
- Mohammad Anadani - Medical University of South CarolinaEyad Almallouhi - Medical University of South CarolinaIlko Maier - University of GöttingenSami Al Kasab - Medical University of South CarolinaPascal Jabbour - Thomas Jefferson UniversityJoon-tae Kim - Chonnam National University HospitalStacey Q Wolfe - Wake Forest UniversityAnsaar Rai - West Virginia University HospitalsRobert M Starke - University of MiamiMarios-Nikos Psychogios - University Hospital of BaselEdgar A Samaniego - University of Iowa Hospitals and ClinicsAdam S Arthur - University of Tennessee Health Science CenterShinichi Yoshimura - Hyogo Medical UniversityHugo Cuellar - Louisiana State University Health Sciences Center ShreveportBrian M Howard - Emory UniversityAli Alawieh - Emory UniversityIsabel Fragata - Unidade Local de Saúde de São JoséAdam J Polifka - University of FloridaJustin R Mascitelli - The University of Texas Health Science Center at San AntonioJoshua W Osbun - Washington University in St. LouisCharles Matouk - Yale UniversityMin S Park - Barrow Neurological InstituteMichael R Levitt - University of WashingtonTravis M Dumont - Department of Surgery, Division of Neurosurgery, University of Arizona/Arizona Health Science Center, Tucson, Arizona, USA.Richard Williamson - Allegheny Health NetworkAlejandro M Spiotta - Medical University of South Carolina
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.15(e3), pp.e414-e418
- DOI
- 10.1136/jnis-2022-019537
- PMID
- 36990690
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group Ltd
- Grant note
- Rapid AI Stryker (http://dx.doi.org/10.13039/100008894) Medtronic (http://dx.doi.org/10.13039/100004374) Pneumbra
- Language
- English
- Electronic publication date
- 03/29/2023
- Date published
- 12/2023
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984381134702771
Metrics
55 Record Views