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Updated: Feb 18, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
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Thrombolysis is an Independent Risk Factor for Poor Outcome After Carotid Revascularization.
Ananth K Vellimana1, Chad W Washington1, Chester K Yarbrough1
1Department of Neurological Surgery, Washington University School of Medi-cine, St. Louis, Missouri.
Neurosurgery
|November 15, 2017
Summary
Thrombolysis for acute ischemic stroke increases risks of hemorrhage and stroke after carotid revascularization. However, these risks decrease significantly within 7 days, suggesting a potential benefit in delaying procedures for stroke patients.
Area of Science:
- Neurology
- Vascular Surgery
- Emergency Medicine
Background:
- Thrombolysis is standard for acute ischemic stroke.
- Early carotid revascularization may reduce recurrent ischemia risk.
- Safety of early revascularization post-thrombolysis is uncertain.
Purpose of the Study:
- Evaluate safety of carotid revascularization in patients treated with thrombolysis for acute ischemic stroke.
Main Methods:
- Analyzed Nationwide Inpatient Sample database for 310,257 patients with carotid stenosis/occlusion.
- Compared outcomes (intracerebral hemorrhage, postprocedural stroke, mortality) between patients receiving thrombolysis (tPA) and those who did not, before carotid endarterectomy (CEA) or angioplasty/stenting (CAS).
Main Results:
- Thrombolysis (tPA) significantly increased risk of intracerebral hemorrhage (ICH) and postprocedural stroke (PPS) after CEA or CAS.
- This elevated risk of ICH/PPS diminished by 7 days post-thrombolysis.
- tPA-treated patients undergoing revascularization had higher rates of poor outcome and in-hospital mortality.
Conclusions:
- Thrombolysis is a significant risk factor for adverse events following carotid revascularization.
- Delaying carotid revascularization after thrombolysis may mitigate risks of ICH and PPS.
- Further research is needed to balance risks of delayed revascularization versus early intervention.
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