Endovascular Treatment With or Without Prior Intravenous Alteplase for Acute Ischemic Stroke
| العنوان: | Endovascular Treatment With or Without Prior Intravenous Alteplase for Acute Ischemic Stroke |
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| المؤلفون: | Chalos, V., LeCouffe, N.E., Uyttenboogaart, M., Lingsma, H.F., Mulder, M.J.H.L., Venema, E., Treurniet, K.M., Eshghi, O., Worp, H.B. van der, Lugt, A. van der, Roos, Y.B.W.E.M., Majoie, C.B.L.M., Dippel, D.W.J., Roozenbeek, B., Coutinho, J.M., Oostenbrugge, R.J. van, Zwam, W.H. van, Boiten, J., Vos, J.A., Jansen, I.G.H., Goldhoorn, R.J.B., Schonewille, W.J., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L.A., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Es, A.C.G.M. van, Bot, J.C.J., Doormaal, P.J. van, Flach, H.Z., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Zweedijk, B., Khalilzada, M., Compagne, K.C.J., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boers, A.M.M., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Kappelhof, M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators |
| المساهمون: | Neurology, Public Health, Radiology & Nuclear Medicine, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Radiology and nuclear medicine, ACS - Atherosclerosis & ischemic syndromes, Graduate School, ACS - Microcirculation, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, MUMC+: MA Med Staf Spec Neurologie (9), Clinical Neurophysiology |
| المصدر: | Journal of the American Heart Association, 8(11):e011592. Wiley Journal of the American Heart Association, 8(11) Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 8 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease Journal of the American Heart Association, 8(11):e011592. Wiley-Blackwell Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 8, 11 Chalos, V, LeCouffe, N E, Uyttenboogaart, M, Lingsma, H F, Mulder, M J H L, Venema, E, Treurniet, K M, Eshghi, O, van der Worp, H B, van der Lugt, A, Roos, Y B W E M, Majoie, C B L M, Dippel, D W J, Roozenbeek, B, Coutinho, J M, van Oostenbrugge, R J, van Zwam, W H, Boiten, J, Vos, J A, Jansen, I G H, Goldhoorn, R-J B, Schonewille, W J, Wermer, M J H, on behalf of the MR CLEAN Registry Investigators, van Walderveen, M A A, Staals, J, Hofmeijer, J, Martens, J M, Lycklama à Nijeholt, G J, Emmer, B J, de Bruijn, S F, van Dijk, L C, Lo, R H, van Dijk, E J, Boogaarts, H D, de Kort, P L M, Peluso, J J P, van den Berg, J S P, van Hasselt, B A A M, Aerden, L A M, Dallinga, R J, Schreuder, T H C M L, Heijboer, R J J, Keizer, K, Yo, L S F, Sprengers, M E S, van den Berg, R, Beenen, L F M, Roosendaal, S D, Bot, J C J, Berkhemer, O A, Boers, A M M, Groot, P F C, Mens, M A, van Kranendonk, K R, Kappelhof, M, Tolhuisen, M L & Alves, H C B R 2019, ' Endovascular Treatment With or Without Prior Intravenous Alteplase for Acute Ischemic Stroke ', Journal of the American Heart Association, vol. 8, no. 11, e011592 . https://doi.org/10.1161/JAHA.118.011592 Journal of the American Heart Association Journal of the American Heart Association, 8(11):011592. Wiley |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, endovascular treatment, Time Factors, medicine.medical_treatment, RECANALIZATION, ANTERIOR CIRCULATION STROKE, THERAPY, law.invention, Brain Ischemia, Workflow, Disability Evaluation, Randomized controlled trial, Modified Rankin Scale, law, Risk Factors, REPERFUSION, Thrombolytic Therapy, Prospective Studies, Registries, Stroke, DIRECT MECHANICAL THROMBECTOMY, Netherlands, Original Research, Aged, 80 and over, OUTCOMES, Confounding, Endovascular Procedures, Atrial fibrillation, Thrombolysis, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Combined Modality Therapy, stroke, Treatment Outcome, thrombectomy, Tissue Plasminogen Activator, Cardiology, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, thrombolysis, Cerebrovascular Procedures, All institutes and research themes of the Radboud University Medical Center, Fibrinolytic Agents, Internal medicine, large vessel occlusion, medicine, Humans, Aged, Ischemic Stroke, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Odds ratio, Recovery of Function, medicine.disease, Cerebrovascular Disease/Stroke, Observational study, business |
| الوصف: | Background It is unclear whether intravenous thrombolysis ( IVT ) with alteplase before endovascular treatment ( EVT ) is beneficial for patients with acute ischemic stroke caused by a large vessel occlusion. We compared clinical and procedural outcomes, safety, and workflow between patients treated with both IVT and EVT and those treated with EVT alone in routine clinical practice. Methods and Results Using multivariable regression, we evaluated the association of IVT + EVT with 90‐day functional outcome (modified Rankin Scale), mortality, reperfusion, first‐pass effect, and symptomatic intracranial hemorrhage in the MR CLEAN (Multicenter Randomised Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands) Registry. Of 1485 patients, 1161 (78%) were treated with IVT + EVT , and 324 (22%) with EVT alone. Patients treated with IVT + EVT had atrial fibrillation less often (16% versus 44%) and had better pre‐stroke modified Rankin Scale scores (pre‐stroke modified Rankin Scale 0: 73% versus 52%) than those treated with EVT alone. Procedure time was shorter in the IVT + EVT group (median 62 versus 68 minutes). Nontransferred IVT + EVT patients had longer door‐to‐groin‐puncture times (median 105 versus 94 minutes). IVT + EVT was associated with better functional outcome (adjusted common odds ratio 1.47; 95% CI : 1.10–1.96) and lower mortality (adjusted odds ratio 0.58; 95% CI : 0.40–0.82). Successful reperfusion, first‐pass effect, and symptomatic intracranial hemorrhage did not differ between groups. Conclusions In this observational study, patients treated with IVT + EVT had better clinical outcomes than patients who received EVT alone. This finding may demonstrate a true benefit of IVT before EVT , but its interpretation is hampered by the possibility of residual confounding and selection bias. Randomized trials are required to properly assess the effect of IVT before EVT . |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 2047-9980 0039-2499 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5849bf50bb655c9b78a43da6e6fcbd1e https://doi.org/10.1161/jaha.118.011592 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....5849bf50bb655c9b78a43da6e6fcbd1e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20479980 00392499 |
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