Impact of Transcranial Doppler Ultrasound on Logistics and Outcomes in Stroke Thrombolysis: Results From the SITS-ISTR

Stroke; a Journal of Cerebral Circulation
Michael V MazyaSITS Investigators

Abstract

Diagnostic transcranial Doppler ultrasound (TCD) is commonly used in patients with acute stroke before or during treatment with intravenous thrombolysis (IVT). We aimed to assess how much TCD delays IVT initiation and whether TCD influences outcomes. We analyzed data from the SITS-ISTR (Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register) collected from December 2002 to December 2011. Outcomes were door-to-needle time, symptomatic intracerebral hemorrhage, functional outcome per the modified Rankin Scale, and mortality at 3 months. In hospitals performing any TCD pre-IVT, 1701 of 11 265 patients (15%) had TCD before IVT initiation. Door-to-needle time was higher in patients with pre-IVT TCD (74 versus 60 minutes; P<0.001). At hospitals performing any TCD during IVT infusion, of 9044 patients with IVT, 747 were examined with TCD during IVT. No treatment delay was seen with TCD during IVT. After multivariate adjustment, TCD during IVT was independently associated with modestly increased excellent functional outcome (modified Rankin Scale, 0-1; adjusted odds ratio, 1.28; 95% confidence interval, 1.06-1.55; P=0.012) and lower mortality (adjusted odds ratio, 0.73; 95% confidence interval, 0.55-0....Continue Reading

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Citations

Oct 9, 2019·International Journal of Stroke : Official Journal of the International Stroke Society·S Al-RuknT Moreira
Feb 20, 2020·The Cochrane Database of Systematic Reviews·Alessia MattioniStefano Ricci
Sep 4, 2020·International Journal of Stroke : Official Journal of the International Stroke Society·Charith CoorayNiaz Ahmed
Jun 16, 2021·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Reza Bavarsad ShahripourThomas Hemmen
Feb 20, 2021·Current Medical Imaging·Antonio SiniscalchiSandro Sanguigni

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