Functional Outcome After Mechanical Thrombectomy with or without Previous Thrombolysis.

Area of Science:

• Neurology
• Cardiovascular Medicine
• Interventional Radiology

Background:

• Combined intravenous therapy (IVT) and mechanical thrombectomy (MT) is standard for acute ischemic stroke (AIS) with large vessel occlusion (LVO).
• The efficacy of administering IVT prior to MT is increasingly debated in clinical practice.

Purpose of the Study:

• To compare outcomes for AIS patients receiving IVT before MT versus MT alone.
• To evaluate the real-world effectiveness of pre-MT IVT in LVO patients.

Main Methods:

• Retrospective analysis of 524 AIS patients with anterior circulation LVO undergoing MT between 2016-2018.
• Comparison of outcomes between patients who received IVT prior to MT (n=347) and those who underwent MT alone (n=177).

Main Results:

• No significant differences in prognosis were observed between the IVT+MT and MT alone groups.
• The MT alone group experienced longer times from stroke onset to CT and groin puncture.
• Independent predictors of good outcome (mRS 0-2) included younger age, absence of cerebral edema, and successful reperfusion (mTICI 2b/3).

Conclusions:

• IVT administered before MT does not appear to influence patient prognosis in a real-world setting.
• The findings suggest that MT alone may be a viable strategy for selected AIS patients with LVO.