دورية أكاديمية
Intra-arterial thrombolytics during endovascular thrombectomy for acute ischaemic stroke in the MR CLEAN Registry
| العنوان: | Intra-arterial thrombolytics during endovascular thrombectomy for acute ischaemic stroke in the MR CLEAN Registry |
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| المؤلفون: | Collette, Sabine L, Bokkers, Reinoud P H, Mazuri, Aryan, Lycklama À Nijeholt, Geert J, van Oostenbrugge, Robert J, LeCouffe, Natalie E, Benali, Faysal, Majoie, Charles B L M, de Groot, Jan Cees, Luijckx, Gert Jan R, Uyttenboogaart, Maarten |
| المصدر: | MR CLEAN Registry Investigators , Collette , S L , Bokkers , R P H , Mazuri , A , Lycklama À Nijeholt , G J , van Oostenbrugge , R J , LeCouffe , N E , Benali , F , Majoie , C B L M , de Groot , J C , Luijckx , G J R & Uyttenboogaart , M 2023 , ' Intra-arterial thrombolytics during endovascular thrombectomy for acute ischaemic stroke in the MR CLEAN Registry ' , Stroke and vascular neurology , vol. 8 , pp. 17-25 . https://doi.org/10.1136/svn-2022-001677Test |
| سنة النشر: | 2023 |
| المجموعة: | University of Groningen research database |
| الوصف: | INTRODUCTION: The efficacy and safety of local intra-arterial (IA) thrombolytics during endovascular thrombectomy (EVT) for large-vessel occlusions is uncertain. We analysed how often IA thrombolytics were administered in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry, whether it was associated with improved functional outcome and assessed technical and safety outcomes compared with EVT without IA thrombolytics. METHODS: In this observational study, we included patients undergoing EVT for an acute ischaemic stroke in the anterior circulation from the MR CLEAN Registry (March 2014-November 2017). The primary endpoint was favourable functional outcome, defined as an modified Rankin Scale score ≤2 at 90 days. Secondary endpoints were reperfusion status, early neurological recovery and symptomatic intracranial haemorrhage (sICH). Subgroup analyses for IA thrombolytics as primary versus adjuvant revascularisation attempt were performed. RESULTS: Of the 2263 included patients, 95 (4.2%) received IA thrombolytics during EVT. The IA thrombolytics administered were urokinase (median dose, 250 000 IU (IQR, 1 93 750-2 50 000)) or alteplase (median dose, 20 mg (IQR, 12-20)). No association was found between IA thrombolytics and favourable functional outcome (adjusted OR (aOR), 1.16; 95% CI 0.71 to 1.90). Successful reperfusion was less often observed in those patients treated with IA thrombolytics (aOR, 0.57; 95% CI 0.36 to 0.90). The odds of sICH (aOR, 0.82; 95% CI 0.32 to 2.10) and early neurological recovery were comparable between patients treated with and without IA thrombolytics. For primary and adjuvant revascularisation attempts, IA thrombolytics were more often administered for proximal than for distal occlusions. Functional outcomes were comparable for patients receiving IA thrombolytics as a primary versus adjuvant revascularisation attempt. CONCLUSION: Local IA thrombolytics were rarely used in the MR CLEAN Registry. In the ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://research.rug.nl/en/publications/444e9945-2d47-464b-a3ae-46522eab4e15Test |
| DOI: | 10.1136/svn-2022-001677 |
| الإتاحة: | https://doi.org/10.1136/svn-2022-001677Test https://hdl.handle.net/11370/444e9945-2d47-464b-a3ae-46522eab4e15Test https://research.rug.nl/en/publications/444e9945-2d47-464b-a3ae-46522eab4e15Test https://pure.rug.nl/ws/files/233397099/Developmental_monitoring_benefits_of_a_preventive_health_care_system.pdfTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.BBD68A3C |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/svn-2022-001677 |
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