Does Intravenous Thrombolysis Influence the Time of Recanalization and Success of Mechanical Thrombectomy during the Acute Phase of Cerebral Infarction?

Abstract

Objectives: Mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke (AIS) caused by large vessel occlusion. Recanalization time is a key factor in the treatment of AIS. It has previously been suggested that intravenous thrombolysis (IVT) may be associated with a shorter recanalization time. The aim of our study was to investigate whether IVT or other factors could be associated with shorter or longer MT procedure times. Methods: We performed a retrospective analysis of a local cohort of patients treated by MT. We collected procedure time (puncture to recanalization and clot visualization to recanalization), demographic data, localization of the thrombus, antithrombotic treatment at arrival, IVT infusion, and stroke subtype at discharge according to the TOAST classification. We planned to analyze the full cohort and the successful revascularization subgroup. Results: There was no difference in procedure times between patients who received IVT and those who did not. In the successful revascularization subgroup, patients presenting with cardioembolic stroke had a significantly shorter time between clot visualizations and revascularization than the other patients (41 vs. 56 min, p = 0.024), but this was not the case in the full cohort. Also in the successful revascularization subgroup, the revascularization time was 76 vs. 61 min (p = 0.075) in patients presenting with tandem occlusion vs. the others, but there was no difference between these groups in the full cohort. Conclusions: There was no difference in terms of procedure times in patients treated by IVT and MT vs. patients treated by MT alone either in the full cohort or in the successful revascularization subgroup. The data from the successful revascularization subgroup may be useful for studying revascularization times, provided that data from procedures that were stopped prematurely by the operator due to the length of time since symptom onset is removed.

Cost-effectiveness of endovascular treatment for acute ischemic stroke in China: evidence from Shandong Peninsula

“…As is well-known, the treatment time window was one of the important factors affecting the choice of treatment for patients with AIS [ 38 , 39 ]. A Chinese study evaluated clinical outcomes and healthcare costs of different time windows of EVT among AIS patients, which was most cost-effective in 1–2 h after the stroke onset compared with other time windows (5–6 h) among patients choosing EVT [ 40 ].…”

The effect of butylphthalide on improving the neurological function of patients with acute anterior circulation cerebral infarction after mechanical thrombectomy

“…[25,26] Butylphthalide is a synthetic racemic n-butylphthalide with the same structure as L-apigenin A. [27] A large number of studies have been carried out on the etiology and pathogenesis of acute cerebral infarction. Although some progress has been made, a unified conclusion has not yet been formed due to its complexity.…”

“…[ 25 , 26 ] Butylphthalide is a synthetic racemic n-butylphthalide with the same structure as L-apigenin A. [ 27 ]…”

Edaravone combined with Shuxuening versus edaravone alone in the treatment of acute cerebral infarction: A systematic review and meta-analysis

“…[10][11][12] With the advancement of medical technology, early thrombolysis, and thrombectomy are important treatments for cerebral infarction. [13] Based on these treatment strategies, how to further improve the prognosis of these patients becomes increasingly apparent.…”