Abstract 1122‐000154: Effect of Intravenous Thrombolysis on Early Clot Lysis in Large Vessel Occlusion Strokes Undergoing Thrombectomy
Introduction: Intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT) are both standard of care treatments for acute ischemic stroke patients with large vessel occlusion (LVO) who are eligible for one or both treatments. IVT may result in early recanalization in some patients with LVO. Th...
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| Format: | Article |
| Language: | English |
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Wiley
2021-11-01
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| Series: | Stroke: Vascular and Interventional Neurology |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.01.suppl_1.000154 |
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| author | Mohamed Shehabeldin Brendan Eby Adam N Wallace Amber Salter Arindam R Chatterjee Joshua W Osbun Christopher J Moran DeWitte T Cross Akash P Kansagra |
| author_facet | Mohamed Shehabeldin Brendan Eby Adam N Wallace Amber Salter Arindam R Chatterjee Joshua W Osbun Christopher J Moran DeWitte T Cross Akash P Kansagra |
| author_sort | Mohamed Shehabeldin |
| collection | DOAJ |
| description | Introduction: Intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT) are both standard of care treatments for acute ischemic stroke patients with large vessel occlusion (LVO) who are eligible for one or both treatments. IVT may result in early recanalization in some patients with LVO. The objective of this study is to analyze whether IVT influences pre‐thrombectomy clot lysis in LVO acute ischemic strokes. Methods: We reviewed prospectively collected data for all patients with LVO ischemic strokes who were transferred to the angiography suite with intention to perform EVT at a single comprehensive stroke center between January 2016 to December 2018. We identified subjects who showed partial or complete clot lysis vs no lysis based on the first angiographic picture of the occluded territory at the time of the initial vessel selection. Descriptive statistics were used to summarize demographic and clinical characteristics. We compared key predictor variables between lysis and no lysis groups including baseline variables, effect of IVT, time from IVT to groin puncture, LVO location, final modified treatment in cerebral ischemia (mTICI) score and discharge Modified Rankin Scale (mRS). t‐test or Kruskal‐Wallis test for continuous variables and chi square test or Fisher’s Exact test for categorical variables. Results: Two hundred and fifty‐nine patients were included. Among these patients, 10.8% (28/259) showed partial or complete lysis of the clot vs 89.2% (231/259) with no lysis. Among these patients who showed clot lysis, 16/28 (57.1%) received IVT. The use of IVT did not show differences between both groups (p = 0.18). There were no differences in the baseline characteristics except for gender, which was the only variable significantly associated with clot lysis. Men had 2‐fold higher odds of spontaneous lysis compared to females (OR [95%CI]: 2.39 [1.01, 5.65], p = 0.04). There was significant difference in the final mTICI between both groups (p <0.001). Conclusions: Our study showed that IVT in a modern practice was not associated with pre‐thrombectomy lysis. Some patients had pre‐thrombectomy lysis despite not receiving IVT. |
| first_indexed | 2024-04-10T21:42:40Z |
| format | Article |
| id | doaj.art-8ae38e807cc2421794b816cb05647282 |
| institution | Directory Open Access Journal |
| issn | 2694-5746 |
| language | English |
| last_indexed | 2024-04-10T21:42:40Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj.art-8ae38e807cc2421794b816cb056472822023-01-18T21:39:24ZengWileyStroke: Vascular and Interventional Neurology2694-57462021-11-011S110.1161/SVIN.01.suppl_1.000154Abstract 1122‐000154: Effect of Intravenous Thrombolysis on Early Clot Lysis in Large Vessel Occlusion Strokes Undergoing ThrombectomyMohamed Shehabeldin0Brendan Eby1Adam N Wallace2Amber Salter3Arindam R Chatterjee4Joshua W Osbun5Christopher J Moran6DeWitte T Cross7Akash P Kansagra8Department of Neurology, Washington University, St Louis Missouri United States of AmericaDepartment of Neurology, Washington University, St Louis Missouri United States of AmericaMallinckrodt Institute of Radiology, Washington University, St Louis Missouri United States of AmericaDivision of Biostatistics, Washington University, St Louis, Missouri, United States of America;Mallinckrodt Institute of Radiology, Washington University, St Louis Missouri United States of AmericaDepartment of Neurology, Washington University, St Louis Missouri United States of AmericaMallinckrodt Institute of Radiology, Washington University, St Louis Missouri United States of AmericaMallinckrodt Institute of Radiology, Washington University, St Louis Missouri United States of AmericaMallinckrodt Institute of Radiology, Washington University, St Louis Missouri United States of AmericaIntroduction: Intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT) are both standard of care treatments for acute ischemic stroke patients with large vessel occlusion (LVO) who are eligible for one or both treatments. IVT may result in early recanalization in some patients with LVO. The objective of this study is to analyze whether IVT influences pre‐thrombectomy clot lysis in LVO acute ischemic strokes. Methods: We reviewed prospectively collected data for all patients with LVO ischemic strokes who were transferred to the angiography suite with intention to perform EVT at a single comprehensive stroke center between January 2016 to December 2018. We identified subjects who showed partial or complete clot lysis vs no lysis based on the first angiographic picture of the occluded territory at the time of the initial vessel selection. Descriptive statistics were used to summarize demographic and clinical characteristics. We compared key predictor variables between lysis and no lysis groups including baseline variables, effect of IVT, time from IVT to groin puncture, LVO location, final modified treatment in cerebral ischemia (mTICI) score and discharge Modified Rankin Scale (mRS). t‐test or Kruskal‐Wallis test for continuous variables and chi square test or Fisher’s Exact test for categorical variables. Results: Two hundred and fifty‐nine patients were included. Among these patients, 10.8% (28/259) showed partial or complete lysis of the clot vs 89.2% (231/259) with no lysis. Among these patients who showed clot lysis, 16/28 (57.1%) received IVT. The use of IVT did not show differences between both groups (p = 0.18). There were no differences in the baseline characteristics except for gender, which was the only variable significantly associated with clot lysis. Men had 2‐fold higher odds of spontaneous lysis compared to females (OR [95%CI]: 2.39 [1.01, 5.65], p = 0.04). There was significant difference in the final mTICI between both groups (p <0.001). Conclusions: Our study showed that IVT in a modern practice was not associated with pre‐thrombectomy lysis. Some patients had pre‐thrombectomy lysis despite not receiving IVT.https://www.ahajournals.org/doi/10.1161/SVIN.01.suppl_1.000154Acute Ischemic Stroke InterventionMechanical ThrombectomyRecanalizationTPA |
| spellingShingle | Mohamed Shehabeldin Brendan Eby Adam N Wallace Amber Salter Arindam R Chatterjee Joshua W Osbun Christopher J Moran DeWitte T Cross Akash P Kansagra Abstract 1122‐000154: Effect of Intravenous Thrombolysis on Early Clot Lysis in Large Vessel Occlusion Strokes Undergoing Thrombectomy Stroke: Vascular and Interventional Neurology Acute Ischemic Stroke Intervention Mechanical Thrombectomy Recanalization TPA |
| title | Abstract 1122‐000154: Effect of Intravenous Thrombolysis on Early Clot Lysis in Large Vessel Occlusion Strokes Undergoing Thrombectomy |
| title_full | Abstract 1122‐000154: Effect of Intravenous Thrombolysis on Early Clot Lysis in Large Vessel Occlusion Strokes Undergoing Thrombectomy |
| title_fullStr | Abstract 1122‐000154: Effect of Intravenous Thrombolysis on Early Clot Lysis in Large Vessel Occlusion Strokes Undergoing Thrombectomy |
| title_full_unstemmed | Abstract 1122‐000154: Effect of Intravenous Thrombolysis on Early Clot Lysis in Large Vessel Occlusion Strokes Undergoing Thrombectomy |
| title_short | Abstract 1122‐000154: Effect of Intravenous Thrombolysis on Early Clot Lysis in Large Vessel Occlusion Strokes Undergoing Thrombectomy |
| title_sort | abstract 1122 000154 effect of intravenous thrombolysis on early clot lysis in large vessel occlusion strokes undergoing thrombectomy |
| topic | Acute Ischemic Stroke Intervention Mechanical Thrombectomy Recanalization TPA |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.01.suppl_1.000154 |
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