Prior IV Thrombolysis Facilitates Mechanical Thrombectomy in Acute Ischemic Stroke

Incomplete Large Vessel Occlusions in Mechanical Thrombectomy: An Independent Predictor of Favorable Outcome in Ischemic Stroke

“…In our study, the overall rate of successful reperfusion (79.9%) is within the range of core-lab controlled results (58.7-88%) [18,19,20,21,22], yet lower than that in self-reported series with reperfusion rates up to 91% [2,3,13,15,16,24,25,26,27]. One putative explanation might be the blinded regrading of all digital subtraction angiography images according to the Cerebral Angiographic Revascularization Grading standards, thereby ensuring common operator-independent grading standards over time.…”

“…Our overall favorable outcome rate (35.3%) is comparable to that of MR CLEAN (32.6%), which can be explained by similar inclusion criteria, periprocedural timings, and the IVT rate [18]. The same holds good in comparison to large case series or registries with favorable outcomes up to 70% [2,3,13,24,26,30,35]. Our rate of concomitant IVT was in line with published registry data and not significantly different between ILVO and CLVO groups [36].…”

“…In underlying large vessel occlusion (LVO), several cofactors affect the functional outcome, for example, anatomic location, patient age, National Institutes of Health Stroke Scale (NIHSS) on admission, angiographic reperfusion result, and concomitant intravenous thrombolysis (IVT) [1,2,3,4]. Clinical outcome improves with swift and complete reperfusion but also depends on the core infarct size in relation to the potentially salvageable tissue (“penumbra”) and collateral status [5,6,7].…”

Impact of intravenous thrombolysis on recanalization rates in patients with stroke treated with bridging therapy

“…Partial but not clinically relevant recanalization after IVT, which we found in 16.9% of the patients, might nevertheless facilitate mechanical recanalization. A study with retrospective group comparison found higher recanalization rates in patients with prior IVT in comparison to EVT [21], whereas others did not find such an association [22][23][24].…”

Comparison of outcome and interventional complication rate in patients with acute stroke treated with mechanical thrombectomy with and without bridging thrombolysis

“…Guedin et al 9 analyzed 68 patients with occlusion of the proximal middle cerebral artery (28 of whom received IVT) treated within 6 h after stroke onset with the Solitaire stent and reported a significantly higher recanalization rate (85.7% vs 55%) and a significantly shorter endovascular procedure time in patients with IVT, while the rates of sICH (7.1% vs 5%) and favorable outcome (67.9% vs 52.5%) were not statistically different. In view of the small study size, the authors did not perform multivariable analysis.…”