Endovascular Therapy versus Thrombolysis in Patients with Mild Strokes and Large Vessel Occlusions within the Anterior Circulation

被引：10

作者：

Kastrup, Andreas ^{[1
,2
]}

Brunner, Freimuth ^{[1
]}

Hildebrandt, Helmut ^{[1
]}

Roth, Christian ^{[3
]}

Winterhalter, Michael ^{[4
]}

Giessing, Carsten ^{[5
]}

Papanagiotou, Panagiotis ^{[3
]}

机构：

[1] Klinikum Bremen Mitte, Dept Neurol, St Jurgen Str 1, DE-28177 Bremen, Germany

[2] Univ Gottingen, Dept Neurol, Gottingen, Germany

[3] Klinikum Bremen Mitte, Dept Neuroradiol, Bremen, Germany

[4] Klinikum Bremen Mitte, Dept Anesthesiol, Bremen, Germany

[5] Carl von Ossietzky Univ Oldenburg, Dept Psychol, Oldenburg, Germany

来源：

INTERVENTIONAL NEUROLOGY | 2018年 / 7卷 / 06期

关键词：

Stroke; Thrombolysis; Thrombectomy; Outcome; Endovascular treatment; Mild stroke;

D O I：

10.1159/000489708

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: In patients with large vessel occlusions, endovascular treatment (ET) has been shown to be superior to intravenous thrombolysis (IVT) in recent trials. However, it is currently unclear if patients with mild strokes also benefit from ET. Methods: We compared the discharge rates of good outcome (modified Rankin scale [mRS] <= 2), very good outcome (mRS 0-1), symptomatic intracranial hemorrhages (SICH), and infarct sizes in patients with mild strokes (admission National Institutes of Health Stroke Scale <= 10) and distal intracranial carotid artery, M1, and M2 occlusions during two time periods. Results: From 1/2008 to 10/2012 160 patients (mean age: 72 +/- 12 years) were treated with IVT, and from 11/2012 to 11/2016 145 patients (mean age: 71 +/- 13 years,) received ET with or without IVT. The clinical results were comparable between both treatment groups (59% after ET vs. 56% after IVT, p = 0.5 for an mRS 0-2) and (38% after ET vs. 32% after IVT, p = 0.3 for an mRS 0-1). In the subgroup of patients with an mRS < 6, the early outcome did not differ significantly between ET and IVT either. The rates of SICH as well as the infarct sizes were not significantly different after ET compared with IVT. Conclusion: Compared with IVT, the routine use of ET did not significantly improve the early clinical or radiological outcome in patients with mild strokes and anterior circulation large vessel occlusions. Further randomized trials are urgently needed to determine the role of ET in this cohort. (C) 2018 S. Karger AG, Basel

引用

页码：431 / 438

页数：8

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