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Most patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke achieve recanalization, but only 30% to 50% have good functional outcomes, potentially because of residual occlusion of microcirculatory vessels. To determine whether the use of intra-arterial thrombolysis after MT might improve these outcomes, researchers conducted a randomized trial across 14 centers in Spain.
The trial involved 433 patients (median age, 76) who underwent MT within 24 hours of stroke onset and had good to excellent recanalization. Half were assigned to receive a 15-minute infusion of intra-arterial tissue plasminogen activator (t-PA) immediately after MT, and half were not. The primary end point was an excellent neurologic outcome, defin…