Clinical imaging factors of excellent outcome after thrombolysis in large-vessel stroke: a THRACE subgroup analysis.

Stroke and Vascular Neurology
Nolwenn Riou-ComteTHRACE investigators

Abstract

For patients with stroke with large-vessel occlusion (LVO), study of factors predicting response to intravenous thrombolysis (IVT) would allow identifying subgroups with high expected gain, and those for whom it could be considered as futile, and even detrimental. From patients included in the Mechanical Thrombectomy After Intravenous Alteplase vs Alteplase Alone After Stroke trial, we investigated clinical-imaging factors associated with optimal response to IVT. We included patients receiving IVT alone. Excellent outcome was defined by a 3-month modified Rankin Scale (mRS) score ≤1. Clinical-imaging predictors were assessed on multivariate analysis after multiple imputations. The predictive performance of the model was assessed with the C-statistic. Among 247 patients with LVO treated with IVT alone, 77 (31%) showed 3-month mRS ≤1. Predictors of 3-month mRS ≤1 were no medical history of hypertension (OR 2.43; 95% CI 1.74 to 3.38; p=0.007); no current smoking (OR 2.76; 95% CI 1.79 to 4.26; p=0.02); onset-to-IVT time (OR 0.47 per hour increase; 95% CI 0.23 to 0.78; p=0.003); diffusion-weighted imaging (DWI) volume (OR 0.78 per 10 mL increase; 95% CI 0.68 to 0.89; p=0.0004); presence of susceptibility vessel sign (SVS) (OR 7.89; ...Continue Reading

References

Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Mar 10, 2001·Stroke; a Journal of Cerebral Circulation·J C GrottaP D Lyden
Oct 15, 2005·Stroke; a Journal of Cerebral Circulation·Pooja KhatriUNKNOWN IMS-I Investigators
Mar 29, 2006·Cerebrovascular Diseases·Marek HumpichTobias Neumann-Haefelin
Feb 3, 2007·Stroke; a Journal of Cerebral Circulation·Joung-Ho Rha, Jeffrey L Saver
Sep 26, 2008·The New England Journal of Medicine·Werner HackeUNKNOWN ECASS Investigators
Sep 24, 2011·Lancet Neurology·Ashfaq ShuaibDavid S Liebeskind
Nov 21, 2012·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Toshinori TakagiYasuaki Nishimura
Aug 8, 2013·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatUNKNOWN STIR Thrombolysis in Cerebral Infarction (TICI) Task Force
Nov 21, 2013·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·María Hernández-PérezAntoni Dávalos
Dec 18, 2013·European Neurology·Yannick BéjotMaurice Giroud
Jan 13, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Joon Hyun BaekOh Young Bang
Jan 31, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Clotilde BalucaniJoseph P Broderick
Apr 23, 2016·Stroke; a Journal of Cerebral Circulation·Siu-Lung ChanMarilyn J Cipolla
Jul 28, 2016·Stroke; a Journal of Cerebral Circulation·Pierre SenersJean-Claude Baron
Jan 28, 2018·Stroke; a Journal of Cerebral Circulation·Mun Hee ChoiJi Man Hong
Feb 21, 2018·Stroke; a Journal of Cerebral Circulation·Alexander H NaveHans Henkes
Apr 26, 2018·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA TNK Investigators
May 7, 2020·The New England Journal of Medicine·Pengfei YangUNKNOWN DIRECT-MT Investigators

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