Impact of intravenous alteplase on sub-angiographic emboli in high-resolution diffusion-weighted imaging following successful thrombectomy.

European Radiology
G BroocksMichael H Schönfeld

Abstract

Thrombus microfragmentation causing peripheral emboli (PE) during mechanical thrombectomy (MT) may modulate treatment effects, even in cases with successful reperfusion. This study aims to investigate whether intravenous alteplase is of potential benefit in reducing PE after successful MT. Patients from a prospective study treated at a tertiary care stroke center between 08/2017 and 12/2019 were analyzed. The main inclusion criterion was successful reperfusion after MT (defined as expanded thrombolysis in cerebral infarction (eTICI) scale ≥ 2b50) of large vessel occlusion anterior circulation stroke. All patients received a high-resolution diffusion-weighted imaging (DWI) follow-up 24 h after MT for PE detection. Patients were grouped as "direct MT" (no alteplase) or as MT plus additional intravenous alteplase. The number and volume of ischemic core lesions and PE were then quantified and analyzed. Fifty-six patients were prospectively enrolled. Additional intravenous alteplase was administered in 46.3% (26/56). There were no statistically significant differences of PE compared by groups of direct MT and additional intravenous alteplase administration regarding mean numbers (12.1, 95% CI 8.6-15.5 vs. 11.1, 95% CI 7.0-15.1; p = ...Continue Reading

References

Jul 6, 2000·Journal of Vascular Surgery·J H RappD Saloner
Mar 16, 2013·Stroke; a Journal of Cerebral Circulation·Ju-Yu ChuehMatthew J Gounis
Jun 12, 2014·Stroke; a Journal of Cerebral Circulation·Kambiz NaelChelsea S Kidwell
Mar 21, 2015·AJNR. American Journal of Neuroradiology·P P GratzM El-Koussy
Jul 15, 2015·Annals of Neurology·Sunil A ShethUNKNOWN SWIFT-STAR Trialists
Jun 13, 2016·Lancet Neurology·William N WhiteleyUNKNOWN Stroke Thrombolysis Trialists' Collaboration
Mar 11, 2017·AJNR. American Journal of Neuroradiology·J KaesmacherT Huber
Aug 3, 2017·Stroke; a Journal of Cerebral Circulation·Marielle ErnstUNKNOWN MR CLEAN Trial Investigators (www.mrclean-trial.org)
May 1, 2018·Journal of Neurointerventional Surgery·Johannes KaesmacherUrs Fischer
May 17, 2018·The New England Journal of Medicine·Tudor G Jovin
May 17, 2018·The New England Journal of Medicine·Götz ThomallaUNKNOWN WAKE-UP Investigators
Sep 9, 2018·Journal of Neurointerventional Surgery·David S LiebeskindUNKNOWN HERMES Collaborators
Mar 13, 2019·Brain : a Journal of Neurology·Gabriel BroocksAndre Kemmling
Sep 19, 2019·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·G BroocksU Hanning
Jan 31, 2020·Journal of Neurology·Michael H SchönfeldUta Hanning
May 7, 2020·The New England Journal of Medicine·Pengfei YangUNKNOWN DIRECT-MT Investigators
Sep 18, 2020·Annals of Neurology·Gabriel BroocksAndre Kemmling

❮ Previous
Next ❯

Citations

Sep 22, 2021·Journal of Neurointerventional Surgery·Gang DengDai-Shi Tian

❮ Previous
Next ❯

Related Concepts

Related Feeds

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

Related Papers

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
L C VermeulenB S Schwartz
Expert Opinion on Pharmacotherapy
Vincent Larrue
Lancet
Gregory W Albers, Jean-Marc Olivot
International Journal of Stroke : Official Journal of the International Stroke Society
Maxim Jhl MulderMR CLEAN investigators
© 2021 Meta ULC. All rights reserved