Abstract WP110: Intravenous Thrombolysis in Acute Ischemic Stroke Patients With Large Vessel Occlusion and Mild Stroke Severity
| Autor: | Peter D. Schellinger, Pablo Garcia-Bermejo, José E. Cohen, Marcel Groen, Nitin Goyal, J D Mocco, Aristeidis H. Katsanos, Violiza Inoa, Adam S Arthur, Mohammad Anadani, Christos Krogias, Panayiotis D. Mitsias, Daniel Hoit, Vivek Sharma, Alexandros Rentzos, Michael T Frohler, Georgios Magoufis, Klearchos Psychogios, Muhammad Waqas, Konark Malhotra, Alejandro M Spiotta, Volker Maus, Maxim Mokin, Christopher Nickele, Georgios Tsivgoulis, Vasileios-Arsenios Lioutas, Meg VanNostrand, Lucas Elijovich, Maher Saqqur, Marios Psychogios, Andrei V Alexandrov, Maurizio Paciaroni, Adnan H. Siddiqui, Hazem Shoirah, Ronen R. Leker |
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| Rok vydání: | 2020 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty business.industry medicine.medical_treatment Mild stroke Thrombolysis medicine.disease Endovascular therapy Internal medicine medicine Cardiology Neurology (clinical) Cardiology and Cardiovascular Medicine business Acute ischemic stroke Stroke Large vessel occlusion |
| Zdroj: | Stroke. 51 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/str.51.suppl_1.wp110 |
| Popis: | Introduction: We investigated the effectiveness of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) and mild neurological deficits defined as National Institutes of Health Stroke Scale scores Methods: The primary efficacy outcome was three-month functional independence (FI; mRS-scores of 0-2) that was compared between patients with and without IVT treatment. Other efficacy outcomes of interest included three-month favorable functional outcome (FFO; mRS-scores of 0-1) and mRS-scores distribution at discharge and at 3 months. The safety outcomes comprised all-cause 3-month mortality, symptomatic intracranial hemorrhage (ICH), asymptomatic ICH and severe systemic bleeding. Results: We evaluated 336 AIS patients with mELVO (mean age: 63±15 years, 45% women). Patients treated with IVT (n=162) had higher FI (85.6% vs. 74.8%, p=0.027) with lower mRS scores at hospital discharge (p=0.034) compared to the rest. Three-month mRS-scores tended to be lower in the IVT group (p=0.069). No differences were detected in any of the safety outcomes including symptomatic ICH, asymptomatic ICH, severe systemic bleeding and 3-month mortality (p>0.1). IVT was associated with higher likelihood of 3-month FI (OR=2.19, 95%CI: 1.09-4.42), 3-month FFO (OR=1.99, 95%CI: 1.10-3.57) and functional improvement at discharge [cOR (per 1-point decrease in mRS-score)=2.94, 95%CI: 1.67-5.26] and at 3 months (cOR=1.72, 95%CI: 1.06-2.86) on multivariable logistic regression models adjusting for potential confounders including mechanical thrombectomy. Conclusion: IVT is independently associated with higher odds of improved discharge and three-month functional outcomes in AIS patients with mELVO. IVT does not increase the risk of systemic or intracranial bleeding. |
| Databáze: | OpenAIRE |
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