NYMC Faculty Publications

Assessment of Thrombectomy Versus Combined Thrombolysis and Thrombectomy in Patients With Acute Ischemic Stroke and Medium Vessel Occlusion

Author Type(s)

Faculty

DOI

10.1148/radiol.233041

Journal Title

Radiology

First Page

233041

Last Page

233041

Document Type

Article

Publication Date

8-2024

Department

Neurosurgery

Keywords

Humans, Female, Male, Aged, Retrospective Studies, Thrombectomy, Ischemic Stroke, Middle Aged, Aged, 80 and over, Thrombolytic Therapy, Combined Modality Therapy, Treatment Outcome, Fibrinolytic Agents, Propensity Score

Disciplines

Medicine and Health Sciences

Abstract

Background The combination of intravenous thrombolysis (IVT) with mechanical thrombectomy (MT) may have clinical benefits for patients with medium vessel occlusion. Purpose To examine whether MT combined with IVT is associated with different outcomes than MT alone in patients with acute ischemic stroke (AIS) and medium vessel occlusion. Materials and Methods This retrospective study included consecutive adult patients with AIS and medium vessel occlusion treated with MT or MT with IVT at 37 academic centers in North America, Asia, and Europe. Data were collected from September 2017 to July 2021. Propensity score matching was performed to reduce confounding. Univariable and multivariable logistic regression analyses were performed to test the association between the addition of IVT treatment and different functional and safety outcomes. Results After propensity score matching, 670 patients (median age, 75 years [IQR, 64-82 years]; 356 female) were included in the analysis; 335 underwent MT alone and 335 underwent MT with IVT. Median onset to puncture (350 vs 210 minutes,

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