Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
| Autor: | Sònia Abilleira, Aida Ribera, Pedro Cardona, Marta Rubiera, Elena López-Cancio, Sergi Amaro, Ana Rodríguez-Campello, Pol Camps-Renom, David Cánovas, Maria Angels de Miquel, Alejandro Tomasello, Sebastian Remollo, Antonio López-Rueda, Elio Vivas, Joan Perendreu, Miquel Gallofré, J. Martí-Fàbregas, R. Delgado-Mederos, A. Martínez-Domeño, R. Marín, J. Roquer, Á. Ois, J. Jiménez-Conde, L. Guimaraens, Á. Chamorro, V. Obach, X. Urra, J.M. Macho, J. Blasco, L. San Roman, A. Martínez-Yélamos, H. Quesada, B Lara, N. Cayuela, L. Aja, P. Mora, C. Molina, M. Ribó, J. Pagola, D. Rodríguez-Luna, M. Muchada, P. Coscojuela, A. Dávalos, M. Millán, N. Pérez de la Ossa, M. Gomis, L. Dorado, C. Castaño, M.C. Garcia, J. Estela, J. Krupinski, S. Huertas-Folch, M.C. Nicolás-Herrerias, M. Gómez-Choco, S. García, R. Martínez, J. Sanahuja, F. Purroy, J. Serena, M. Castellanos, Y. Silva, R. Marés, A. Pellisé, X. Ustrell, J.J. Baiges, M. Garcés, J. Saura, J.M. Soler-Insa, J.M. Aragonés, D. Cocho, E. Palomeras |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine medicine Humans Thrombolytic Therapy Prospective Studies Registries Endovascular treatment Intensive care medicine Stroke Aged Thrombectomy Advanced and Specialized Nursing Aged 80 and over business.industry Endovascular Procedures Thrombolysis Middle Aged medicine.disease Combined Modality Therapy Treatment Outcome Administration Intravenous Female Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Stroke. 48(2) |
| ISSN: | 1524-4628 |
| Popis: | Background and Purpose— Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients. Methods— Using region-wide registry data, we selected cases that received direct EVT or combined intravenous thrombolysis+EVT for anterior circulation strokes between January 2011 and October 2015. Treatment effect was estimated by stratification on a propensity score. The average odds ratios for the association of treatment with good outcome and death at 3 months and symptomatic bleedings at 24 hours were calculated with the Mantel–Haenszel test statistic. Results— We included 599 direct EVT patients and 567 patients with combined treatment. Stratification through propensity score achieved balance of baseline characteristics across treatment groups. There was no association between treatment modality and good outcome (odds ratio, 0.97; 95% confidence interval, 0.74–1.27), death (odds ratio, 1.07; 95% confidence interval, 0.74–1.54), or symptomatic bleedings (odds ratio, 0.56; 95% confidence interval, 0.25–1.27). Conclusions— This observational study suggests that outcomes after direct EVT or combined intravenous thrombolysis+EVT are not different. If confirmed by a randomized controlled trial, it may have a significant impact on organization of stroke systems of care. |
| Databáze: | OpenAIRE |
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