Why the study?
The impact of combined IV rt-PA and additional antithrombotic therapy within 24 hours during emergency neuroendovascular revascularization for atherothrombotic large vessel occlusion was unclear.
Does intravenous rt-PA and additional antithrombotic agents within 24 hours improve functional outcomes or recanalization rates in patients with atherothrombotic large vessel occlusion undergoing emergency neuroendovascular revascularization?
Does intravenous rt-PA and additional antithrombotic agents within 24 hours improve functional outcomes or recanalization rates in patients with atherothrombotic large vessel occlusion undergoing emergency neuroendovascular revascularization?
In patients with atherothrombotic large vessel occlusion undergoing endovascular revascularization, concomitant IV rt-PA and the addition of antithrombotic agents within 24 hours did not significantly impact 90-day functional outcomes or increase hemorrhagic complications.
No functional benefit with IV rt-PA despite higher recanalization without it; leaves open RCTs on bridging in atherothrombotic LVO.
【背景と目的】アテローム血栓性脳主幹動脈閉塞（AT-LVO）に対する急性期脳血管内血行再建術（ENER）時のrt-PA静注療法（IV rt-PA）併用や24時間以内の抗血栓薬追加投与の影響は明確でない．当院でENERを施行したAT-LVOに対するIV rt-PAと24時間以内抗血栓療法の影響を検討した．【方法】発症4.5時間以内に受診しENERを施行したAT-LVO 60例を，IV rt-PA併用群26例，非併用群34例，に分け後方視的に検討した．【結果】有効再開通率はIV rt-PA非併用群で有意に高いが90日後転帰良好例に差はみられなかった．24時間以内抗血栓薬投与の有無でも頭蓋内出血合併率や90日後転帰良好例に差はみられなかった．【結論】ENERを施行したAT-LVOにおいて，IV rt-PAとその24時間以内の抗血栓薬療法は出血性合併症率や90日後転帰に影響を与えなかった．
No takes yet. Share an insight, caveat, or question.
Miyazaki et al. (2023) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: