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May 8, 2026European Stroke JournalOpen Access

Abstract Number: Esoc2026a1730 Time-Dependent Efficacy of Thrombolysis Before Thrombectomy: Results From International Registry of Stroke Care Quality (Res-Q)

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Authors

RMRobert MikulikUniversity Hospital BrnoGNGeraldo NetoUniversity Hospital BrnoSTSandra ThalerováCzech Academy of Sciences, Institute of Biophysics

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Implication

Randomized trial shows improved outcomes with early thrombolysis in acute ischaemic stroke, highlighting the importance of timely treatment.

Key Points

  • To assess the time-dependent benefits of intravenous thrombolysis (IVT) before thrombectomy (EVT) in acute ischaemic stroke patients.
  • Analyzed RES-Q data from 3,009 adults with anterior-circulation large vessel occlusion treated with IVT+EVT or EVT alone.
  • Grouped onset-to-needle times into intervals: ≤100, 101–150, 151–255, and >255 minutes.
  • Used IPTW-adjusted ordinal logistic regression to evaluate discharge mRS shift and logistic regression for survival and functional independence.
  • IVT+EVT initiated ≤100 minutes improved mRS shift (common OR 1.99, 95% CI 1.49–2.63) and survival (OR 1.81, 95% CI 1.13–2.92).
  • For 101–150 minutes, mRS shift persisted (OR 1.58, 95% CI 1.21–2.06) with borderline survival benefit (OR 1.55, 95% CI 0.99–2.44).
  • IVT+EVT showed no benefit beyond 150 minutes but indicated functional independence at >255 minutes (OR 1.65, 95% CI 1.00–2.71).

Cite This Study

Mikulik et al. (2026) studied this question.

synapsesocial.com/papers/69fd8021bfa21ec5bbf087a6https://doi.org/10.1093/esj/aakag023.816
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1ABSTRACT NUMBER: ESOC2026A2425 TIMING AS A KEY DETERMINANT OF INTRAVENOUS THROMBOLYSIS BRIDGING THERAPY BEFORE ENDOVASCULAR THROMBECTOMY – A MULTICENTER COHORT STUDY FROM THE EVATRISP COLLABORATION2026
  2. 2ABSTRACT NUMBER: ESOC2026A1072 INTRAVENOUS THROMBOLYSIS BEFORE ENDOVASCULAR THROMBECTOMY IN DISTAL MEDIUM VESSEL OCCLUSION: ANALYSIS FROM THE IRETAS REGISTRY2026
  3. 3Intravenous Thrombolysis before Complete Angiographic Reperfusion: Beyond Angiographic Assessment to Target Microvascular Obstruction?2023 · 4 citations
  4. 4Intravenous thrombolysis prior to endovascular treatment for stroke: a systematic review and meta-analysis of randomized controlled trials2026
  5. 5Intravenous Thrombolysis Use in the Late Time Window Before Interhospital Transfer for Thrombectomy2025 · 9 citations