Journal article
The effect of intravenous thrombolysis in stroke patients with unsuccessful thrombectomy
Interventional neuroradiology, p.15910199241279009
09/12/2024
DOI: 10.1177/15910199241279009
PMCID: PMC11559907
PMID: 39262342
Abstract
Background The benefit of intravenous thrombolysis (IVT) is well established. We aim to study the benefits of IVT in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) who underwent unsuccessful mechanical thrombectomy (MT). Methods We included AIS patients who underwent MT for anterior circulation LVO with failed recanalization (modified treatment in cerebral ischemia [mTICI] score ≤ 2A). Patients who received IVT prior to MT were compared to those who received MT alone. Propensity score matching using demographic, clinical, radiographic and procedural variables was used to match patients with and without IVT. The primary outcome was favorable 90-day good functional outcome (defined as modified Rankin scale of 0–2), and secondary outcomes included intracranial hemorrhage (ICH), symptomatic ICH (sICH), and 90-day mortality. Results Totally, 610 AIS patients with unsuccessful MT were included. After propensity matching, 219 patients were identified in each group. Median age was 70 years and 73 years in the IVT + MT and MT alone groups, respectively. In the IVT + MT group, final mTICI scores of 0, 1, and 2A were achieved in 92 (42.0%), 33 (15.1%), and 94 (42.9%) patients, respectively, versus 76 (34.7%), 29 (13.2%), and 114 (52.1%) in the MT alone group. The IVT + MT group had greater odds of 90-day good functional outcome (adjusted odds ratio 2.54, 95% confidence interval 1.53–4.32). There were no significant differences in secondary outcomes. Conclusions IVT is associated with improved functional outcomes in AIS patients with LVO despite unsuccessful MT.
Details
- Title: Subtitle
- The effect of intravenous thrombolysis in stroke patients with unsuccessful thrombectomy
- Creators
- Sameh Samir Elawady - Medical University of South CarolinaRahim Abo Kasem - Medical University of South CarolinaHidetoshi Matsukawa - Medical University of South CarolinaConor Cunningham - Medical University of South CarolinaMohamed Mahdi Sowlat - Medical University of South CarolinaNoah Lee Nawabi - Medical University of South CarolinaAtakan Orscelik - University of California, San FranciscoJoshua M Venegas - Medical University of South CarolinaJulio Isidor - Medical University of South CarolinaHasna Loulida - Medical University of South CarolinaIlko Maier - Universitätsmedizin GöttingenPascal Jabbour - Jefferson University HospitalsJoon-Tae Kim - Chonnam National University HospitalStacey Quintero Wolfe - Wake Forest UniversityAnsaar Rai - West Virginia UniversityRobert M Starke - University of Miami Health SystemMarios-Nikos Psychogios - University of BaselEdgar A Samaniego - University of IowaNitin Goyal - University of Tennessee Health Science CenterShinichi Yoshimura - University of California, San FranciscoHugo Cuellar - Louisiana State University in ShreveportBrian Howard - Emory UniversityAli Alawieh - Emory UniversityAli Alaraj - University of Illinois ChicagoMohamad Ezzeldin - Lone Star College KingwoodDaniele G Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'AragonaOmar Tanweer - Baylor College of MedicineJustin Mascitelli - The University of Texas Health Science Center at San AntonioIsabel Fragata - Hospital de São JoséAdam Polifka - University of FloridaFazeel Siddiqui - West HealthJoshua Osbun - Washington University in St. LouisRamesh Grandhi - University of UtahRoberto Crosa - Department of Neurosurgery, Endovascular Neurological Center, Montevideo, UruguayCharles Matouk - Yale UniversityMin S Park - University of VirginiaMichael R Levitt - University of WashingtonWaleed Brinjikji - Mayo Clinic in ArizonaMark Moss - J. B. Hunt Transport Services (United States)Ergun Daglioglu - Ankara Bilkent City HospitalRichard Williamson - Allegheny Health NetworkPedro Navia - Hospital Universitario La PazPeter Kan - The University of Texas Medical Branch at GalvestonReade De Leacy - Mount Sinai Health SystemShakeel Chowdhry - NorthShore University HealthSystemDavid J Altschul - Montefiore Medical CenterAlejandro M Spiotta - Medical University of South CarolinaSami Al Kasab - Medical University of South Carolina
- Resource Type
- Journal article
- Publication Details
- Interventional neuroradiology, p.15910199241279009
- DOI
- 10.1177/15910199241279009
- PMID
- 39262342
- PMCID
- PMC11559907
- NLM abbreviation
- Interv Neuroradiol
- ISSN
- 1591-0199
- eISSN
- 2385-2011
- Publisher
- SAGE PUBLICATIONS INC
- Grant note
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research support from Penumbra, Microvention, Medtronic, Stryker, RapidAI, and Brain Aneurysm Foundation.
- Language
- English
- Electronic publication date
- 09/12/2024
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984704833102771
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