Thrombus Length Predicts Lack of Post-Thrombolysis Early Recanalization in Minor Stroke With Large Vessel Occlusion

Stroke; a Journal of Cerebral Circulation
Pierre SenersPREDICT-RECANAL Collaborators

Abstract

Background and Purpose- Whether bridging therapy, that is, intravenous thrombolysis [IVT] followed by mechanical thrombectomy, is beneficial as compared with IVT alone in minor stroke (National Institutes of Health Stroke Scale ≤5) with large vessel occlusion is unknown and should be tested in randomized trials. To help select the most appropriate candidates for such trials, we aimed to identify strong predictors of lack of post-IVT early recanalization (ER)-a surrogate marker of poor outcome. Methods- From a large multicenter French registry of patients with large vessel occlusion referred for thrombectomy immediately after IVT start between 2015 and 2017, we extracted 97 minor strokes with ER evaluated on first angiographic run or noninvasive imaging ≤3 hours from IVT start. Thrombus length was measured using the susceptibility vessel sign on T2* imaging. Results- Median National Institutes of Health Stroke Scale was 3 (interquartile range, 2-4), and occlusion sites were proximal (intracranial carotid or M1) and distal (M2) in 50% and 50% of patients, respectively. On pre-IVT MRI, median length of susceptibility vessel sign (visible in 90%) was 9.2 mm (interquartile range, 7.4-13.3). ER was present in 34% of patients, and sus...Continue Reading

References

Feb 3, 2007·Stroke; a Journal of Cerebral Circulation·Joung-Ho Rha, Jeffrey L Saver
Jul 28, 2016·Stroke; a Journal of Cerebral Circulation·Pierre SenersJean-Claude Baron
Nov 2, 2017·Stroke; a Journal of Cerebral Circulation·Cyril DargazanliUNKNOWN ETIS REGISTRY Investigators
Dec 8, 2017·Stroke; a Journal of Cerebral Circulation·Georgios TsivgoulisAndrei V Alexandrov

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Citations

Mar 10, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·G TsivgoulisA V Alexandrov
Dec 29, 2020·World Neurosurgery·Xiao WuAjay Malhotra
May 15, 2021·Journal of Neurointerventional Surgery·Nerea Arrarte TerrerosCharles B L M Majoie
Apr 10, 2021·Journal of Thrombosis and Haemostasis : JTH·Maxime GaubertiDenis Vivien

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