This title appears in the Scientific Report :
2019
Please use the identifier:
http://dx.doi.org/10.1007/s13760-018-0892-1 in citations.
Relevance of standard intravenous thrombolysis in endovascular stroke therapy of a tertiary stroke center
Relevance of standard intravenous thrombolysis in endovascular stroke therapy of a tertiary stroke center
The majority of patients undergoing endovascular stroke treatment (EST) in randomized controlled trials received additional systemic thrombolysis (“combination or bridging therapy (C/BT)”). Nevertheless, its usefulness in this subtype of acute ischemic stroke (AIS) is discussed controversially. Of a...
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Personal Name(s): | Heinrichs, Annette |
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Nikoubashman, Omid / Schürmann, Kolja / Tauber, Simone C. / Wiesmann, Martin / Schulz, Jörg B. / Reich, Arno (Corresponding author) | |
Contributing Institute: |
JARA-BRAIN; JARA-BRAIN Jara-Institut Quantum Information; INM-11 |
Published in: | Acta neurologica Belgica, 118 (2018) 1, S. 105 - 111 |
Imprint: |
Milan
Springer
2018
|
DOI: |
10.1007/s13760-018-0892-1 |
PubMed ID: |
29435828 |
Document Type: |
Journal Article |
Research Program: |
(Dys-)function and Plasticity |
Publikationsportal JuSER |
The majority of patients undergoing endovascular stroke treatment (EST) in randomized controlled trials received additional systemic thrombolysis (“combination or bridging therapy (C/BT)”). Nevertheless, its usefulness in this subtype of acute ischemic stroke (AIS) is discussed controversially. Of all consecutive AIS patients, who received any kind of reperfusion therapy in a tertiary university stroke center between January 2015 and March 2016, those with large vessel occlusions (LVO) and EST with or without additional C/BT, were compared primarily regarding procedural aspects. Data were extracted from an investigator-initiated, single-center, prospective and blinded end-point study. 70 AIS patients with EST alone and 118 with C/BT were identified. Significant baseline differences existed in pre-existing cardiovascular disease (52.9% (EST alone) vs. 35.6% (C/BT), p = 0.023), use of anticoagulation (30.6% vs. 5.9%, p < 0.001), and frequency of unknown time of symptom onset (65.7% vs. 32.2%, p < 0.001), in-hospital stroke (18.6% vs. 1.7%, p < 0.001), pre-treatment ASPECT scores (7.9 vs. 8.9, p = 0.004), and frequency of occlusion in the posterior circulation (18.6% vs. 5.1%, p = 0.003). Pre-interventional procedural time intervals tended to be shorter in the C/BT group, reaching statistical significance in door-to-image time (30.3 (EST alone) vs. 22.2 min (C/BT), p < 0.001). Good clinical outcome (mRS d90) was reached more often in the C/BT group (24.5% vs. 11.8%, p = 0.064). Rates of symptomatic intracranial hemorrhages (sICH) were comparable (4.3% (EST alone) vs. 6.8% (C/BT), p = 0.481). Additional systemic thrombolysis did not delay EST. On the contrary, application of IVRTPA seemed to be a positive indicator for faster EST without increased side effects. |