Introduction: The aim of this study was to compare the outcomes of patients treated with intravenous thrombolysis (IVT) <4.5 h after symptom onset plus mechanical thrombectomy (MT) <6 h with those treated with IVT alone <4.5 h for minor stroke (NIHSS ≤5) with large vessel occlusion (LVO) in the anterior circulation. Patients and methods: Patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) and in the Italian centers included in the SITS-ISTR were analyzed. Results: Among the patients with complete data on 24-h ICH type, 236 received IVT plus MT and 382 received IVT alone. IVT plus MT was significantly associated with unfavorable shift on 24-h ICH types (from no ICH to PH-2) (OR, 2.130; 95% CI, 1.173-3.868; p=0.013) and higher rate of PH (OR, 4.363; 95% CI, 1.579-12.055; p=0.005), sICH per ECASS II definition (OR, 5.527; 95% CI, 1.378-22.167; p=0.016), and sICH per NINDS definition (OR, 3.805; 95% CI, 1.310-11.046; p=0.014). Among the patients with complete data on 3-month mRS score, 226 received IVT plus MT and 262 received IVT alone. No significant difference was reported between IVT plus MT and IVT alone on mRS score 0-1 (72.1% versus 69.1%), mRS score 0-2 (79.6% versus 79%), and death (6.2% versus 6.1%). Conclusions: Compared with IVT alone, IVT plus MT was associated with unfavorable shift on 24-h ICH types and higher rate of 24-h PH and sICH in patients with minor stroke and LVO in the anterior circulation. However, no difference was reported between the groups on 3-month functional outcome measures.
IV thrombolysis plus thrombectomy versus IV thrombolysis alone for minor stroke with anterior circulation large vessel occlusion from the IRETAS and Italian SITS-ISTR cohorts / Cappellari, M.; Pracucci, G.; Saia, V.; Fainardi, E.; Casetta, I.; Sallustio, F.; Ruggiero, M.; Longoni, M.; Simonetti, L.; Zini, A.; Lazzarotti, G. A.; Giannini, N.; Da Ros, V.; Diomedi, M.; Vallone, S.; Bigliardi, G.; Limbucci, N.; Nencini, P.; Ajello, D.; Marcheselli, S.; Burdi, N.; Boero, G.; Bracco, S.; Tassi, R.; Boghi, A.; Naldi, A.; Biraschi, F.; Nicolini, E.; Castellan, L.; Del Sette, M.; Allegretti, L.; Sugo, A.; Buonomo, O.; Dell'Aera, C.; Saletti, A.; De Vito, A.; Lafe, E.; Mazzacane, F.; Bergui, M.; Cerrato, P.; Feraco, P.; Piffer, S.; Augelli, R.; Vit, F.; Gasparotti, R.; Magoni, M.; Comelli, S.; Melis, M.; Menozzi, R.; Scoditti, U.; Cavasin, N.; Critelli, A.; Causin, F.; Baracchini, C.; Guzzardi, G.; Tarletti, R.; Filauri, P.; Orlandi, B.; Giorgianni, A.; Cariddi, L. P.; Piano, M.; Motto, C.; Gallesio, I.; Sepe, F. N.; Romano, G.; Grasso, M. F.; Pauciulo, A.; Rizzo, A.; Comai, A.; Franchini, E.; Sicurella, L.; Galvano, G.; Mannino, M.; Mangiafico, S.; Toni, D.. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - 44:12(2023), pp. 4401-4410. [10.1007/s10072-023-06948-w]
IV thrombolysis plus thrombectomy versus IV thrombolysis alone for minor stroke with anterior circulation large vessel occlusion from the IRETAS and Italian SITS-ISTR cohorts
Feraco P.;Romano G.;Comai A.;
2023-01-01
Abstract
Introduction: The aim of this study was to compare the outcomes of patients treated with intravenous thrombolysis (IVT) <4.5 h after symptom onset plus mechanical thrombectomy (MT) <6 h with those treated with IVT alone <4.5 h for minor stroke (NIHSS ≤5) with large vessel occlusion (LVO) in the anterior circulation. Patients and methods: Patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) and in the Italian centers included in the SITS-ISTR were analyzed. Results: Among the patients with complete data on 24-h ICH type, 236 received IVT plus MT and 382 received IVT alone. IVT plus MT was significantly associated with unfavorable shift on 24-h ICH types (from no ICH to PH-2) (OR, 2.130; 95% CI, 1.173-3.868; p=0.013) and higher rate of PH (OR, 4.363; 95% CI, 1.579-12.055; p=0.005), sICH per ECASS II definition (OR, 5.527; 95% CI, 1.378-22.167; p=0.016), and sICH per NINDS definition (OR, 3.805; 95% CI, 1.310-11.046; p=0.014). Among the patients with complete data on 3-month mRS score, 226 received IVT plus MT and 262 received IVT alone. No significant difference was reported between IVT plus MT and IVT alone on mRS score 0-1 (72.1% versus 69.1%), mRS score 0-2 (79.6% versus 79%), and death (6.2% versus 6.1%). Conclusions: Compared with IVT alone, IVT plus MT was associated with unfavorable shift on 24-h ICH types and higher rate of 24-h PH and sICH in patients with minor stroke and LVO in the anterior circulation. However, no difference was reported between the groups on 3-month functional outcome measures.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione
