Can Thrombolysis Be Avoided Prior to Thrombectomy for Acute Ischemic Stroke?

A randomized trial found thrombectomy alone to be noninferior to thrombectomy plus thrombolysis.

In studies establishing the utility of endovascular thrombectomy (EVT) for patients with acute ischemic stroke, patients also received treatment with a thrombolytic agent such as alteplase if they could be treated within a 4.5-hour time window, but there have been concerns that thrombolysis could increase the risk for brain hemorrhage and lead to delays in initiation of EVT. Now, researchers have conducted a randomized trial comparing EVT alone to EVT plus alteplase in 656 patients (median age, 69) at 41 healthcare centers in China. Median NIH stroke scale score was 17; median duration from randomization to groin puncture was 31 minutes in the EVT-alone group and 36 minutes in the combination-treatment group. The primary endpoint was the sc…

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

Can Thrombolysis Be Avoided Prior to Thrombectomy for Acute Ischemic Stroke?

Topics

Reviewing Author