Endovascular Thrombectomy with or without Intravenous Thrombolysis for Anterior Circulation Large Vessel Occlusion in the Imperial College London Thrombectomy Registry

被引：7

作者：

D'Anna, Lucio ^{[1
,2
]}

Foschi, Matteo ^{[3
]}

Russo, Michele ^{[4
]}

Dolkar, Tsering ^{[1
]}

Vittay, Orsolya ^{[1
]}

Dixon, Luke ^{[5
]}

Bentley, Paul ^{[1
]}

Brown, Zoe ^{[1
]}

Hall, Charles ^{[5
]}

Halse, Omid ^{[1
]}

Jamil, Sohaa ^{[1
]}

Jenkins, Harri ^{[1
]}

Kalladka, Dheeraj ^{[1
]}

Kwan, Joseph ^{[1
]}

Malik, Abid ^{[1
]}

Patel, Maneesh ^{[5
]}

Rane, Neil ^{[5
]}

Roi, Dylan ^{[5
]}

Singh, Abhinav ^{[5
]}

Venter, Marius ^{[1
]}

Lobotesis, Kyriakos ^{[5
]}

Banerjee, Soma ^{[1
,2
]}

机构：

[1] Imperial Coll London NHS Healthcare Trust, Charing Cross Hosp, Dept Stroke & Neurosci, London W6 8RF, England

[2] Imperial Coll London, Dept Brain Sci, London SW7 2AZ, England

[3] Univ Laquila, Dept Biotechnol & Appl Clin Sci, I-67100 Laquila, Italy

[4] S Maria Battuti Hosp, Dept Cardiol, AULSS 2 Veneto, I-31015 Conegliano, Italy

[5] Imperial Coll London, Charing Cross Hosp, Dept Imaging, NHS Healthcare Trust,Neuroradiol, London W6 8RF, England

来源：

JOURNAL OF CLINICAL MEDICINE | 2023年 / 12卷 / 03期

关键词：

mechanical thrombectomy; intravenous thrombolysis; large vessel occlusion; ischemic stroke; ACUTE ISCHEMIC-STROKE; ALTEPLASE; TRIAL;

D O I：

10.3390/jcm12031150

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and purpose. Mechanical thrombectomy (MT) is the standard of care for eligible patients with a large vessel occlusion (LVO) acute ischemic stroke. Among patients undergoing MT there has been uncertainty regarding the role of intravenous thrombolysis (IVT) and previous trials have yielded conflicting results regarding clinical outcomes. We aim to investigate clinical, reperfusion outcomes and safety of MT with or without IVT for ischemic stroke due to anterior circulation LVO. Materials and Methods. This observational, prospective, single-centre study included consecutive patients with acute LVO ischemic stroke of the anterior circulation. The primary outcomes were the rate of in-hospital mortality, symptomatic intracranial haemorrhage and functional independence (mRS 0-2 at 90 days). Results. We enrolled a total of 577 consecutive patients: 161 (27.9%) were treated with MT alone while 416 (72.1%) underwent IVT and MT. Patients with MT who were treated with IVT had lower rates of in-hospital mortality (p = 0.037), higher TICI reperfusion grades (p = 0.007), similar rates of symptomatic intracranial haemorrhage (p = 0.317) and a higher percentage of functional independence mRS (0-2) at 90 days (p = 0.022). Bridging IVT with MT compared to MT alone was independently associated with a favorable post-intervention TICI score (>2b) (OR, 1.716; 95% CI, 1.076-2.735, p = 0.023). Conclusions. Our findings suggest that combined treatment with MT and IVT is safe and results in increased reperfusion rates as compared to MT alone.

引用

页数：9

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