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BACKGROUND:The effectiveness of intravenous thrombolysis (IVT) before endovascular treatment (EVT) has been investigated in randomized trials and meta-analyses. These studies mainly concerned anterior circulation occlusions. All patients with a posterior circulation occlusion were included.
Safety outcomes were any intracerebral hemorrhage (ICH) and symptomatic ICH (sICH) at 24-36hrs. Background:Patients with acute ischemic stroke and a large vessel occlusion (LVO) admitted to primary stroke centers (PSC) often require inter-facility transfer for thrombectomy.
Background:Symptomatic intracranial hemorrhage (sICH) is the most dreaded complication after reperfusion therapy for acute ischemic stroke. Results:MT in the anterior circulation was associated with a significantly higher risk of sICH as compared with no-MT (RR: 1.46; 95%CI: 1.03-2.07; 2.07; P = 0.037). 1.03; P = 0.079).
Background and Aims:Endovascular treatment (EVT) alone has been confirmed to be non-inferior to intravenous thrombolysis (IVT) followed with EVT in acute ischemic stroke (AIS) due to large-vessel occlusion of the anterior circulation. Stroke, Volume 56, Issue Suppl_1 , Page AWP253-AWP253, February 1, 2025.
IntroductionIntracranial atherosclerotic disease (ICAD) is associated with up to 32% of posterior circulation strokes.1 Rescue treatment with stenting, balloon angioplasty, and/or intraarterial thrombolysis or antiplatelets are often required to treat the underlying stenosis.
Posterior circulation tandem occlusion was defined as stroke due to intracranial vertebral (V4), basilar, or posterior cerebral artery (PCA) occlusions, with tandem steno-occlusive lesion >70% of the extracranial vertebral artery and impaired distal flow or partial filling of the VA from collaterals.
Background:The effectiveness and safety of intravenous Tirofiban as an adjunct to endovascular therapy (EVT) in posterior circulation patients with tandem lesions (PCTL) remain uncertain.Methods:This study utilized individual patient data pooled from two multicenter observational studies: the BASILAR and the PERSIST registries.
Secondary outcomes were in‐hospital mortality, intracerebral hemorrhage, and length of stay. In multivariable models, intravenous thrombolysis was independently associated with higher odds of routine discharge (adjusted OR, 1.78; 95% CI, 1.57–2.01;P<0.001) The primary outcome was routine discharge (home or self‐care).
We defined two binary outcomes: (1) functional clinical outcome (modified Rankin Scale 0-2) and (2) early symptomatic intracerebral hemorrhage (sICH). Among patients who underwent emergency intracranial stenting, 66 (30.6%) received intravenous thrombolytic treatment.
The primary outcome measure was successful recanalization defined as modified Thrombolysis in Cerebral Ischemia (mTICI) score of 2b or higher. 90-day modified Rankin score (mRS) 0-2, mortality and symptomatic hemorrhage were used as secondary outcomes.
Prolonged ICU stay were more likely to have higher baseline median NIHSS score (19 vs. 14%, p < 0.0001), posterior circulation stroke (12.6% vs. 6.1%, p = 0.0326), and symptomatic intracerebral hemorrhage (7.3% Patients receiving thrombolysis prior to thrombectomy were less likely to have a prolonged LOS (27.8%
IntroductionPosterior circulation strokes account for 20% of ischemic strokes (1). Optimal management for posterior circulation strokes has been studied less than for anterior circulation strokes (2). Following embolization, repeat imaging showed no new infarcts and no new or worsening hemorrhage.
Background:Atrial fibrillation (AF) has been shown to be associated with better procedural outcomes in patients with anterior circulation large vessel occlusion (aLVO) undergoing endovascular therapy (EVT). Forty-four percent of the no AC group received intravenous thrombolysis (IVT). In the NOAC group, 59.5%
IntroductionCurrent evidence supports endovascular therapy (EVT) for eligible patients with acute ischemic stroke in the anterior and posterior circulation. 1.56, P= 0.28; I2 = 26%, Figure A) and the results of the anterior circulation subgroup showed non‐statistically significant difference (OR = 1.22, 95% CI: 0.90–1.67,
Here, we investigate the association of middle cerebral artery(MCA) tortuosity on radiographic and functional outcome.Methods:The Analysis of Revascularization in Ischemic Stroke with EmboTrap II was utilized to identify patients with anterior circulation stroke. Likewise, the rate of mTICI≥2c was higher in group A (54.5%) vs 36.4%
Reperfusion following thrombectomy in the anterior cerebral circulation has long been graded by the modified Thrombolysis in Cerebral Infarction (mTICI) scale-and the score of mTICI (2b, or, “partial filling of more than 50% of the affected vascular territory” is considered the benchmark for “good” outcomes in EVT.
A failed MT was defined as a modified Thrombolysis in Cerebral Infarction (mTICI) score of 0 to 2a after multiple attempts to clot retrieval. Additional outcomes included functional independence (defined as a 90‐day mRS score of 0‐2), symptomatic intracranial hemorrhage (sICH), and mortality at 90 days.
Best Medical Therapy in Acute Ischemic Stroke due to Large VEssel OcclusioN Trial in the Extended Time Window: Raul Nogueira, University of Pittsburgh, Pittsburgh, PA MOST Multi-Arm Optimization of Stroke Thrombolysis Trial: Opeolu Adeoye, Washington University, Saint Louis, MO Thurs.,
Anterior circulation AIS patients with large vessel occlusion were grouped based on the presence of a CBF core, defined as either 0 mL or greater than 0 mL, with a relative CBF less than 30% of normally perfused tissue on CT perfusion imaging. The primary outcome was a modified Rankin Scale (mRS) score of 0-2 at 90 days. 2.25, p=0.04).Conclusions:Stroke
Outcomes included complications, NIHSS at discharge, final modified TICI (thrombolysis in cerebral ischemia) scores including the first‐pass effect (FPE, defined as mTICI 2c/3 after first pass), modified‐FPE (defined as, mTICI 2b‐3 after first pass), symptomatic intracranial hemorrhage (SITS‐MOST definition), and death at discharge.
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