Key result
Intravenous thrombolysis before endovascular therapy was associated with a favorable shift in 90-day disability (aOR 1.41; 95% CI 1.04-1.91; p=0.023) compared to endovascular therapy alone.
Why the study?
Ineffective tissue reperfusion despite successful angiographic reperfusion may cause unfavorable outcomes after EVT and might be modulated by IVT use before EVT.
Does intravenous thrombolysis before endovascular therapy improve 90-day disability in patients with ischemic stroke who achieve complete angiographic reperfusion?
Population
1,093 stroke patients with anterior LVO and complete reperfusion after EVT within 6 hours
Comparison
IVT before EVT vs EVT alone
Design
Multicenter prospective observational registry study with propensity score matching
Follow-up
90 days
Authors
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May support bridging IVT before EVT in select patients; extends observational data but leaves open need for RCTs.
Observational (n=1,093)
Yes
Does intravenous thrombolysis before endovascular therapy improve 90-day disability in patients with ischemic stroke who achieve complete angiographic reperfusion?
Odds Ratio: 1.41 (95% CI 1.04–1.91)
p-value: p=0.023
Prior intravenous thrombolysis improves 90-day clinical outcomes in ischemic stroke patients who achieve complete angiographic reperfusion with endovascular therapy, without increasing bleeding risk.
Gory et al. (2023) conducted an observational in Ischemic Stroke (n=1,093). Intravenous thrombolysis (IVT) before endovascular therapy (EVT) vs. Endovascular therapy alone (without prior IVT) was evaluated on Shift in the degree of disability as measured by the modified Rankin Scale (mRS) at 90 days (aOR 1.41, 95% CI 1.04-1.91, p=0.023). Intravenous thrombolysis before endovascular therapy was associated with a favorable shift in 90-day disability (aOR 1.41; 95% CI 1.04-1.91; p=0.023) compared to endovascular therapy alone.