Is Bridging with Intravenous Thrombolysis of Any Benefit in Endovascular Therapy for Acute Ischemic Stroke?

Objective Large vessel occlusions with heavy clot burden are less likely to improve with intravenous (IV) thrombolysis alone. The purpose of this study was to show whether a combination of IV thrombolysis and endovascular therapy was superior to endovascular treatment alone. Methods Data for 104 pat...

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Bibliographic Details
Published in:World neurosurgery 2014-09, Vol.82 (3), p.e453-e458
Main Authors: Kass-Hout, Tareq, Kass-Hout, Omar, Mokin, Maxim, Thesier, Danielle M, Yashar, Parham, Orion, David, Jahshan, Shady, Hopkins, L. Nelson, Siddiqui, Adnan H, Snyder, Kenneth V, Levy, Elad I
Format: Article
Language:English
Subjects:
Acute ischemic stroke
Brain Ischemia - mortality
Brain Ischemia - surgery
Brain Ischemia - therapy
Bridging
Cerebral Infarction - therapy
Endovascular Procedures - methods
Female
Fibrinolytic Agents - administration & dosage
Fibrinolytic Agents - therapeutic use
Humans
Intra-arterial therapy
Male
Neurosurgery
Retrospective Studies
Stroke - mortality
Stroke - surgery
Stroke - therapy
Thrombolytic Therapy - methods
Tissue plasminogen activator
Tissue Plasminogen Activator - administration & dosage
Tissue Plasminogen Activator - therapeutic use
Treatment Outcome
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Summary:Objective Large vessel occlusions with heavy clot burden are less likely to improve with intravenous (IV) thrombolysis alone. The purpose of this study was to show whether a combination of IV thrombolysis and endovascular therapy was superior to endovascular treatment alone. Methods Data for 104 patients with acute large artery occlusion treated between 2005 and 2010 were reviewed. Forty-two received endovascular therapy in combination with IV thrombolysis (bridging group), and 62 received endovascular therapy only. Clinical outcome, mortality rate, and symptomatic intracranial hemorrhage (sICH) rate were compared between the two groups. Results The two groups had similar demographic and vascular risk factor distribution, as well as National Institutes of Health Stroke Scale score on admission (mean ± SD: 14.8 ± 4.7 and 16.0 ± 5.3; P  = 0.23). No difference was found in Thrombolysis in Myocardial Infarction recanalization rates (score of 2 or 3) after combined or endovascular therapy alone (83.33% and 79.03%; P  = 0.585). Favorable outcome, defined as a modified Rankin Scale score of
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2013.01.097