Intraarterial Thrombolysis as Rescue Therapy for Large Vessel Occlusions

Stroke; a Journal of Cerebral Circulation
Syed F ZaidiOsama O Zaidat

Abstract

Background and Purpose- Mechanical thrombectomy (MT) devices have led to improved reperfusion and clinical outcomes in acute ischemic stroke patients with emergent large vessel occlusions; however, less than one-third of patients achieve complete reperfusion. Use of intraarterial thrombolysis in the context of MT may provide an opportunity to enhance these results. Here, we evaluate the use of intraarterial rtPA (recombinant tissue-type plasminogen activator) as rescue therapy (RT) after failed MT in the North American Solitaire Stent-Retriever Acute Stroke registry. Methods- The North American Solitaire Stent-Retriever Acute Stroke registry recruited sites within North America to submit data on acute ischemic stroke patients treated with the Solitaire device. After restricting the population of 354 patients to use of RT and anterior emergent large vessel occlusions, we compared patients who were treated with and without intraarterial rtPA after failed MT. Results- A total of 37 and 44 patients was in the intraarterial rtPA RT and the no intraarterial rtPA RT groups, respectively. Revascularization success (modified Thrombolysis in Cerebral Infarction ≥2b) was achieved in more intraarterial rtPA RT patients (61.2% versus 46.6%;...Continue Reading

References

Feb 9, 2013·The New England Journal of Medicine·Joseph P BroderickUNKNOWN Interventional Management of Stroke (IMS) III Investigators
Dec 18, 2014·The New England Journal of Medicine·Olvert A BerkhemerUNKNOWN MR CLEAN Investigators
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Feb 12, 2015·The New England Journal of Medicine·Mayank GoyalUNKNOWN ESCAPE Trial Investigators
Apr 18, 2015·The New England Journal of Medicine·Jeffrey L SaverUNKNOWN SWIFT PRIME Investigators
Apr 18, 2015·The New England Journal of Medicine·Tudor G JovinUNKNOWN REVASCAT Trial Investigators
Feb 19, 2016·Stroke; a Journal of Cerebral Circulation·Bruce C V CampbellMayank Goyal
Aug 28, 2017·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Daniel M HeifermanWilliam W Ashley
Feb 21, 2018·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatRaul G Nogueira

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Citations

Jun 13, 2019·Stroke; a Journal of Cerebral Circulation·Alicia C CastonguaySyed F Zaidi
Jun 13, 2019·Stroke; a Journal of Cerebral Circulation·Chuanjie WuXunming Ji
Oct 1, 2020·Stroke; a Journal of Cerebral Circulation·Johannes KaesmacherUrs Fischer
Dec 20, 2019·International Journal of Stroke : Official Journal of the International Stroke Society·Arturo RenúUNKNOWN CHOICE Investigators
Aug 8, 2020·Stroke; a Journal of Cerebral Circulation·Jeffrey L SaverUNKNOWN Distal Thrombectomy Summit Group*†
Dec 5, 2019·Frontiers in Neurology·Alicia C CastonguaySyed F Zaidi
Jul 10, 2020·Journal of Neurointerventional Surgery·Haowen XuPanxing Li
Jan 30, 2021·AJNR. American Journal of Neuroradiology·S F ZaidiM A Jumaa
Feb 19, 2021·Scientific Reports·Robert T KlevenChristy K Holland
Feb 23, 2021·Stroke; a Journal of Cerebral Circulation·Vanessa H E ChenLeonard L L Yeo
Apr 10, 2021·Journal of Neurointerventional Surgery·Lisa R SunMonica S Pearl
Apr 10, 2021·Journal of Thrombosis and Haemostasis : JTH·Maxime GaubertiDenis Vivien
Dec 24, 2021·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Hiroaki NekiYuichiro Kikkawa

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