학술논문
IV thrombolysis plus thrombectomy versus IV thrombolysis alone for minor stroke with anterior circulation large vessel occlusion from the IRETAS and Italian SITS-ISTR cohorts
Document Type
Original Paper
Author
Cappellari, Manuel; Pracucci, Giovanni; Saia, Valentina; Fainardi, Enrico; Casetta, Ilaria; Sallustio, Fabrizio; Ruggiero, Maria; Longoni, Marco; Simonetti, Luigi; Zini, Andrea; Lazzarotti, Guido Andrea; Giannini, Nicola; Da Ros, Valerio; Diomedi, Marina; Vallone, Stefano; Bigliardi, Guido; Limbucci, Nicola; Nencini, Patrizia; Ajello, Daniele; Marcheselli, Simona; Burdi, Nicola; Boero, Giovanni; Bracco, Sandra; Tassi, Rossana; Boghi, Andrea; Naldi, Andrea; Biraschi, Francesco; Nicolini, Ettore; Castellan, Lucio; Del Sette, Massimo; Allegretti, Luca; Sugo, Annalisa; Buonomo, Orazio; Dell’Aera, Cristina; Saletti, Andrea; De Vito, Alessandro; Lafe, Elvis; Mazzacane, Federico; Bergui, Mauro; Cerrato, Paolo; Feraco, Paola; Piffer, Silvio; Augelli, Raffaele; Vit, Federica; Gasparotti, Roberto; Magoni, Mauro; Comelli, Simone; Melis, Maurizio; Menozzi, Roberto; Scoditti, Umberto; Cavasin, Nicola; Critelli, Adriana; Causin, Francesco; Baracchini, Claudio; Guzzardi, Giuseppe; Tarletti, Roberto; Filauri, Pietro; Orlandi, Berardino; Giorgianni, Andrea; Cariddi, Lucia Princiotta; Piano, Mariangela; Motto, Cristina; Gallesio, Ivan; Sepe, Federica Nicoletta; Romano, Giuseppe; Grasso, Maria Federico; Pauciulo, Alfredo; Rizzo, Annalisa; Comai, Alessio; Franchini, Enrica; Sicurella, Luigi; Galvano, Gianluca; Mannino, Marina; Mangiafico, Salvatore; Toni, Danilo; on behalf of the IRETAS group
Source
Neurological Sciences. 44(12):4401-4410
Subject
Language
English
ISSN
1590-1874
1590-3478
1590-3478
Abstract
Introduction: The aim of this study was to compare the outcomes of patients treated with intravenous thrombolysis (IVT) <4.5 h after symptom onset plus mechanical thrombectomy (MT) <6 h with those treated with IVT alone <4.5 h for minor stroke (NIHSS ≤5) with large vessel occlusion (LVO) in the anterior circulation.Patients and methods: Patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) and in the Italian centers included in the SITS-ISTR were analyzed.Results: Among the patients with complete data on 24-h ICH type, 236 received IVT plus MT and 382 received IVT alone. IVT plus MT was significantly associated with unfavorable shift on 24-h ICH types (from no ICH to PH-2) (OR, 2.130; 95% CI, 1.173–3.868; p=0.013) and higher rate of PH (OR, 4.363; 95% CI, 1.579–12.055; p=0.005), sICH per ECASS II definition (OR, 5.527; 95% CI, 1.378–22.167; p=0.016), and sICH per NINDS definition (OR, 3.805; 95% CI, 1.310–11.046; p=0.014). Among the patients with complete data on 3-month mRS score, 226 received IVT plus MT and 262 received IVT alone. No significant difference was reported between IVT plus MT and IVT alone on mRS score 0–1 (72.1% versus 69.1%), mRS score 0–2 (79.6% versus 79%), and death (6.2% versus 6.1%).Conclusions: Compared with IVT alone, IVT plus MT was associated with unfavorable shift on 24-h ICH types and higher rate of 24-h PH and sICH in patients with minor stroke and LVO in the anterior circulation. However, no difference was reported between the groups on 3-month functional outcome measures.