In acute ischemic stroke, EVT alone vs. IV alteplase plus EVT did not differ for functional outcome at 90 d

Area of Science:

• Neurology
• Cardiovascular Medicine
• Emergency Medicine

Background:

• Stroke is a leading cause of long-term disability.
• Endovascular treatment has shown efficacy for acute ischemic stroke.
• The role of intravenous alteplase as a pre-treatment before endovascular therapy remains under investigation.

Purpose of the Study:

• To determine if intravenous alteplase administered before endovascular treatment improves functional outcomes in patients with acute ischemic stroke.
• To evaluate the safety and efficacy of bridging therapy in stroke management.

Main Methods:

• A randomized controlled trial involving patients with acute ischemic stroke.
• Participants were assigned to receive either intravenous alteplase before endovascular treatment or endovascular treatment alone.
• Functional outcomes were assessed using validated scales at specified follow-up intervals.

Main Results:

• No significant difference was observed in the primary functional outcome between the group receiving alteplase before endovascular treatment and the group receiving endovascular treatment alone.
• Secondary outcomes, including rates of intracranial hemorrhage and overall mortality, were comparable between the two groups.
• The study demonstrated the safety of administering intravenous alteplase in conjunction with endovascular procedures.

Conclusions:

• Pre-treatment with intravenous alteplase before endovascular treatment does not significantly improve functional outcomes for patients with acute ischemic stroke.
• Endovascular treatment alone is a viable and effective strategy for selected stroke patients.
• Further research may explore specific patient subgroups who might benefit from bridging therapy.