Direct Mechanical Thrombectomy vs. Bridging Therapy in Stroke Patients in A "Stroke Belt" Region of Southern Europe.

Autor: Del Toro-Pérez C; Stroke Centre, Department of Neurology, Torrecárdenas University Hospital, University of Almería, 04009 Almería, Spain., Amaya-Pascasio L; Stroke Centre, Department of Neurology, Torrecárdenas University Hospital, University of Almería, 04009 Almería, Spain., Guevara-Sánchez E; Stroke Centre, Department of Neurology, Torrecárdenas University Hospital, University of Almería, 04009 Almería, Spain., Ruiz-Franco ML; Stroke Centre, Department of Neurology, Torrecárdenas University Hospital, University of Almería, 04009 Almería, Spain., Arjona-Padillo A; Stroke Centre, Department of Neurology, Torrecárdenas University Hospital, University of Almería, 04009 Almería, Spain., Martínez-Sánchez P; Stroke Centre, Department of Neurology, Torrecárdenas University Hospital, University of Almería, 04009 Almería, Spain.; Faculty of Health Sciences, CEINSA (Center of Health Research), University of Almería, 04120 Almería, Spain.
Jazyk: angličtina
Zdroj: Journal of personalized medicine [J Pers Med] 2023 Feb 28; Vol. 13 (3). Date of Electronic Publication: 2023 Feb 28.
DOI: 10.3390/jpm13030440
Abstrakt: The aim of this 4-year observational study is to analyze the outcomes of stroke patients treated with direct mechanical thrombectomy (dMT) compared to bridging therapy (BT) (intravenous thrombolysis [IVT] + BT) based on 3-month outcomes, in real clinical practice in the "Stroke Belt" of Southern Europe. In total, 300 patients were included (41.3% dMT and 58.6% BT). The frequency of direct referral to the stroke center was similar in the dMT and BT group, whereas the time from onset to groin was longer in the BT group (median 210 [IQR 160-303] vs. 399 [IQR 225-675], p = 0.001). Successful recanalization (TICI 2b-3) and hemorrhagic transformation were similar in both groups. The BT group more frequently showed excellent outcomes at 3 months (32.4% vs. 15.4%, p = 0.004). Multivariate analysis showed that BT was independently associated with excellent outcomes (OR 2.7. 95% CI,1.2-5.9, p = 0.02) and lower mortality (OR 0.36. 95% CI 0.16-0.82, p = 015). Conclusions: Compared with dMT, BT was associated with excellent functional outcomes and lower 3-month mortality in this real-world clinical practice study conducted in a region belonging to the "Stroke Belt" of Southern Europe. Given the disparity of results on the benefit of BT in the current evidence, it is of vital importance to analyze the convenience of its use in each health area.
Databáze: MEDLINE