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Multicenter Study
. 2023 Nov;15(e2):e229-e231.
doi: 10.1136/jnis-2022-019522. Epub 2022 Oct 28.

Intravenous thrombolysis upon flow restoration improves outcome in endovascular thrombectomy

Johannes M Weller  1 , Franziska Dorn  2 , Gabor C Petzold #  3   4 , Felix J Bode #  1 ; GSR-ET investigators
Collaborators, Affiliations
Multicenter Study

Intravenous thrombolysis upon flow restoration improves outcome in endovascular thrombectomy

Johannes M Weller et al. J Neurointerv Surg. 2023 Nov.

Abstract

Background: We hypothesized that ongoing IV thrombolysis (IVT) at flow restoration in patients with acute ischemic stroke (AIS) treated with IVT and endovascular thrombectomy (ET) is associated with improved outcome.

Methods: We included patients with IVT and successful recanalization (modified Thrombolysis in Cerebral Infarction score ≥2b) after ET from an observational multicenter cohort, the German Stroke Registry - Endovascular Treatment trial. Procedural characteristics and functional outcome at discharge and 90 days were compared between patients with and without ongoing IVT at flow restoration. To determine associations with functional outcome, adjusted ORs were calculated using ordinal multivariable logistic regression models adjusted for potential baseline confounder variables.

Results: Among 1303 patients treated with IVT and ET who achieved successful recanalization, IVT was ongoing in 13.8% (n=180) at flow restoration. Ongoing IVT was associated with better functional outcome at discharge (adjusted OR 1.61; 95% CI 1.13 to 2.30) and at 90 days (adjusted OR 1.52; 95% CI 1.06 to 2.18).

Conclusion: These results provide preliminary evidence for a benefit of ongoing IVT at flow restoration in patients with AIS treated with ET.

Keywords: Stroke; Thrombectomy; Thrombolysis.

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Conflict of interest statement

Competing interests: FJD is a consultant/proctor for Cerenovus/Johnson&Johnson, Balt, Cerus Endovascular and Phenox. She received speakers honoraria from Acandis, Stryker, Cerenovus/Johnson&Johnson, Asahi and research support from Cerenovus/Johnson&Johnson. She serves as an associate editor for the Journal of NeuroInterventional Surgery.

Figures

Figure 1
Figure 1
Functional outcome in patients with acute ischemic stroke treated with thrombectomy and IV thrombolysis (IVT) with and without ongoing IVT at flow restoration. Distribution of modified Rankin Scale (mRS) scores at 90 days follow-up.
See this image and copyright information in PMC

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