Should Thrombolysis Be Withheld in Acute Stroke Patients Receiving Thrombectomy?

Post hoc comparison of mechanical thrombectomy with and without prior intravenous thrombolysis showed similar outcomes, supporting a randomized trial.

In patients with acute stroke who have been treated with mechanical thrombectomy (MT) in clinical trials, most received prior treatment with intravenous thrombolysis (IVT). However, administering IVT takes some time and carries the risk of brain hemorrhage.

These authors conducted a manufacturer-sponsored post hoc analysis of two studies that assessed the Solitaire MT device. Overall, 291 patients (mean age 68; median NIH Stroke Scale score, 17) were included in the analysis, 160 with IVT plus MT and 131 with MT alone. The researchers looked at outcomes including angiographic reperfusion, outcomes at 90 days, and symptomatic intracranial hemorrhage. About two thirds of the patients had proximal middle cerebral artery occlusion.

Rates of succe…

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

Should Thrombolysis Be Withheld in Acute Stroke Patients Receiving Thrombectomy?

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Reviewing Author