Intravenous Recombinant Tissue-Type Plasminogen Activator: Influence on Outcome in Anterior Circulation Ischemic Stroke Treated by Mechanical Thrombectomy

Stroke; a Journal of Cerebral Circulation
Marc FerrignoH Hénon

Abstract

Intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) improves functional outcome in patients with ischemic stroke related to proximal-vessel occlusion in the anterior circulation. Whether MT alone is as effective as IVT/MT remains controversial. We aimed at evaluating the influence of IVT in patients with large anterior circulation artery occlusion treated with MT. We did a prospective observational cohort study in patients with stroke related to large anterior circulation artery occlusion treated by MT who were admitted to Lille University Hospital, Lille, France. We evaluated the influence of IVT on favorable functional outcome (defined as a modified Rankin Scale score 0-2 or similar to the prestroke modified Rankin Scale) and on mortality at month 3. Between-group comparisons in outcomes were adjusted for prespecified confoundors by using a propensity score-adjusted approach. From January 2012 to January 2017, we included 485 patients (median age, 68 years; 46% men; 348 [72%] in the IVT/MT group; 137 [28%] in the MT group). In MT group, 22% of patients had a favorable outcome versus 35% in IVT/MT group (adjusted relative risk, 1.76; 95% confidence interval, 1.23-2.55). Mortality within 3 months occurred le...Continue Reading

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Citations

Apr 17, 2019·The Neuroradiology Journal·Yasuhiro KawabataTetsuya Tsukahara
Dec 12, 2018·Journal of Neurointerventional Surgery·Mohammad AnadaniAlejandro Spiotta
Nov 22, 2018·Current Opinion in Neurology·Aristeidis H Katsanos, Georgios Tsivgoulis
Oct 18, 2018·Cardiovascular and Interventional Radiology·M BretznerN Bricout
Oct 21, 2020·Journal of Thrombosis and Thrombolysis·Mingming ZhaXinfeng Liu
Nov 18, 2018·World Neurosurgery·Nasreddine NouriNicolas Bricout

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