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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.

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Title: 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.
Authors: Cappellari, Manuel (AUTHOR), Pracucci, Giovanni (AUTHOR), Saia, Valentina (AUTHOR), Fainardi, Enrico (AUTHOR), Casetta, Ilaria (AUTHOR), Sallustio, Fabrizio (AUTHOR), Ruggiero, Maria (AUTHOR), Longoni, Marco (AUTHOR), Simonetti, Luigi (AUTHOR), Zini, Andrea (AUTHOR), Lazzarotti, Guido Andrea (AUTHOR), Giannini, Nicola (AUTHOR), Da Ros, Valerio (AUTHOR), Diomedi, Marina (AUTHOR), Vallone, Stefano (AUTHOR), Bigliardi, Guido (AUTHOR), Limbucci, Nicola (AUTHOR), Nencini, Patrizia (AUTHOR), Ajello, Daniele (AUTHOR), Marcheselli, Simona (AUTHOR)
Source: Neurological Sciences. Dec2023, Vol. 44 Issue 12, p4401-4410. 10p.
Subjects: Stroke, Thrombectomy, Thrombolytic therapy, Endovascular surgery, Functional groups, Intracerebral hematoma, Basilar artery
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. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: 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.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cappellari%2C+Manuel%22&quot;&gt;Cappellari, Manuel&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pracucci%2C+Giovanni%22&quot;&gt;Pracucci, Giovanni&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Saia%2C+Valentina%22&quot;&gt;Saia, Valentina&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fainardi%2C+Enrico%22&quot;&gt;Fainardi, Enrico&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Casetta%2C+Ilaria%22&quot;&gt;Casetta, Ilaria&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sallustio%2C+Fabrizio%22&quot;&gt;Sallustio, Fabrizio&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ruggiero%2C+Maria%22&quot;&gt;Ruggiero, Maria&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Longoni%2C+Marco%22&quot;&gt;Longoni, Marco&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Simonetti%2C+Luigi%22&quot;&gt;Simonetti, Luigi&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zini%2C+Andrea%22&quot;&gt;Zini, Andrea&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lazzarotti%2C+Guido+Andrea%22&quot;&gt;Lazzarotti, Guido Andrea&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Giannini%2C+Nicola%22&quot;&gt;Giannini, Nicola&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Da+Ros%2C+Valerio%22&quot;&gt;Da Ros, Valerio&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Diomedi%2C+Marina%22&quot;&gt;Diomedi, Marina&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Vallone%2C+Stefano%22&quot;&gt;Vallone, Stefano&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bigliardi%2C+Guido%22&quot;&gt;Bigliardi, Guido&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Limbucci%2C+Nicola%22&quot;&gt;Limbucci, Nicola&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nencini%2C+Patrizia%22&quot;&gt;Nencini, Patrizia&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ajello%2C+Daniele%22&quot;&gt;Ajello, Daniele&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Marcheselli%2C+Simona%22&quot;&gt;Marcheselli, Simona&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Neurological+Sciences%22&quot;&gt;Neurological Sciences&lt;/searchLink&gt;. Dec2023, Vol. 44 Issue 12, p4401-4410. 10p.
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  Data: Introduction: The aim of this study was to compare the outcomes of patients treated with intravenous thrombolysis (IVT) &lt;4.5 h after symptom onset plus mechanical thrombectomy (MT) &lt;6 h with those treated with IVT alone &lt;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. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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