Intravenous fibrinolysis plus endovascular thrombectomy versus direct endovascular thrombectomy for anterior circulation acute ischemic stroke: clinical and infarct volume results

Autor: Angelo Costa, M. Frigerio, Dikran Mardighian, Filomena Caria, Loris Poli, Mauro Magoni, Nicola Gilberti, Veronica Vergani, Enrico Premi, Roberto Gasparotti, Valeria De Giuli, Raffaella Spezi, Andrea Morotti, Alessandro Pezzini, Alessandro Padovani, Ilenia Delrio, Massimo Gamba
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
Endovascular therapy
Logistic regression
Single Center
lcsh:RC346-429
Intravenous thrombolysis
03 medical and health sciences
0302 clinical medicine
Fibrinolytic Agents
Internal medicine
Fibrinolysis
medicine
Humans
Thrombolytic Therapy
030212 general & internal medicine
Administration
Intravenous stroke/*therapy Thrombectomy/*methods ischemic stroke
lcsh:Neurology. Diseases of the nervous system
Aged
Retrospective Studies
Thrombectomy
Intracerebral hemorrhage
Aged
80 and over
Ischemic stroke
Cerebral infarction
business.industry
Retrospective cohort study
General Medicine
Thrombolysis
Recovery of Function
Middle Aged
medicine.disease
Stroke
Treatment Outcome
Large vessels occlusion
Tissue Plasminogen Activator
Infarct volume
Administration
Cardiology
Administration
Intravenous
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Combined therapy
Intravenous stroke/*therapy Thrombectomy/*methods ischemic stroke
Research Article
Zdroj: BMC Neurology, Vol 19, Iss 1, Pp 1-6 (2019)
BMC Neurology
ISSN: 1471-2377
Popis: Background and Purpose endovascular therapy (ET) is the standard of care for anterior circulation acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). The role of adjunctive intravenous thrombolysis (IVT) in these patients is still unclear. The present study aims to test whether IVT plus ET (CoT, combined therapy) provides additional benefits over direct ET for anterior circulation AIS by LVO. Methods we performed a single center retrospective observational study of patients with AIS caused by anterior circulation LVO, referred to our center between January 2014 and January 2017 and treated with ET. The patients were divided in 2 groups based on the treatment they received: CoT and, if IVT contraindicated, direct ET. We compared functional recovery (modified Rankin at 3-months follow-up), recanalization rate (thrombolysis in cerebral infarction [TICI] score) and time, early follow-up infarct volume (EFIV) (for recanalized patients only) as well as safety profile, defined as symptomatic intracerebral hemorrhage (sICH) and 3-month mortality, between groups. Results 145 subjects were included in the study, 70 in direct ET group and 75 in CoT group. Patients who received CoT presented more frequently a functional independence at 3-months follow-up compared to patients who received direct ET (mRS score 0-1: 48.5% vs 18.6%; P
Databáze: OpenAIRE
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