Thrombolysis to Dissolve Intraventricular Hemorrhage Lacks Efficacy in Phase III Trial

The primary outcome of modified Rankin Scale score ≤3 at 180 days did not differ between patients who received alteplase and those who didn't — perhaps because clot removal was limited in most patients.

In patients with intracerebral hemorrhage (ICH), extension of the hemorrhage to the ventricular system is a marker for a poor outcome. Reported mortality rates exceed 50% in some studies. Intraventricular hemorrhage (IVH) can manifest with decreased level of consciousness and it increases the risk of hydrocephalus. Removing the blood with a thrombolytic agent, along with extraventricular drainage, could improve outcomes for these patients.

In this multicenter, phase III trial, researchers randomly assigned 500 patients to treatment with either alteplase or saline within 52 hours after hemorrhagic stroke onset. Patients had to have an extraventricular drain in the intensive care unit, and the ICH had to be <30 mL with IVH obstructing the thir…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Thrombolysis to Dissolve Intraventricular Hemorrhage Lacks Efficacy in Phase III Trial

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Reviewing Author