Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionEfficacy and safety of intravenous thrombolysis (IVT) in patients undergoing mechanical thrombectomy (MT) is still debatable. However, IVT's efficacy on stent retriever (SR) and aspiration thrombectomy (ASP) outcomes specifically remain unclear. ResultsWe included four randomized controlled trials with 1176 patients.

Thrombolysis 40

Thrombolysis Outcomes Embolism Stents 40

Stroke Journal

JANUARY 30, 2025

The safety of the treatment was evaluated based on the occurrence of any complications, the occurrence of intracerebral hemorrhage, and the occurrence of symptomatic intracerebral hemorrhage (assessed according to SITS-MOST criteria).Results:44 A good clinical outcome (mRS 90day 2) was achieved by 61.4%. men, average age 71.512.2

Thrombolysis 40

Thrombolysis Stroke Strokes Hemorrhage 40

Stroke Journal

JANUARY 30, 2025

Background:The prognostic significance of the affected hemisphere in hemorrhagic stroke remains uncertain. We aimed to determine the relationship between the affected hemisphere (right or left) and differences in non-motor outcomes (pain, mood) in patients with acute intracerebral hemorrhage (ICH).

Quality of Life 40

Quality of Life Hemorrhage Outcomes Thrombolysis 40

Stroke Journal

JANUARY 30, 2025

Background:Previous study found that compared with thrombolysis, antiplatelet did not improve outcomes but reduce the risk of symptomatic intracranial hemorrhage(sICH) for mild acute ischemic stroke(AIS) defined as National Institutes of Health Stroke Scale score 0 to 5. to 1.35]; mRS 0-2, odds ratio, 1.06 [95% CI, 0.73

Thrombolysis 40

Thrombolysis Stroke Strokes Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

Definitions of symptomatic HT developed during the intravenous thrombolysis (IVT) era are outdated in the endovascular thrombectomy (EVT) era but continue to be widely used. Symptomatic hemorrhages were due to subarachnoid hemorrhage in more than half and PH-2 in only one-quarter of symptomatic hemorrhages in this EVT series.

Hemorrhage 40

Hemorrhage Outcomes Thrombolysis Stroke 40

Stroke Journal

JANUARY 30, 2025

Background:Cerebral amyloid angiopathy (CAA) is a hemorrhagic cerebrovascular disease that is thought to be due to excess protein deposition in vessel walls that lead to fragility and increase the risk of rupture. Primary outcome was routine discharge to home with self-care. to 5.75], p<0.001), and SAH (aOR 2.42 [95%CI 1.41-4.16],

Thrombolysis 40

Thrombolysis Stroke Strokes Cerebrovascular Disease 40

Stroke Journal

MARCH 8, 2024

mg/kg]) comparing IVT with placebo or standard treatment from the EOS (Evaluation of Unknown-Onset Stroke Thrombolysis trial) data set. mg/kg]) comparing IVT with placebo or standard treatment from the EOS (Evaluation of Unknown-Onset Stroke Thrombolysis trial) data set. Death occurred in 4.0% and 0.3%, respectively (P=0.194).

Thrombolysis 40

Thrombolysis Stroke Strokes Hemorrhage 40

Stroke Journal

JANUARY 30, 2025

hour window, and reperfusion through thrombolysis has been shown to enhance functional outcomes in patients with salvageable brain tissue beyond this timeframe.Objective:The aim of this study is to assess the efficacy and safety of thrombolysis administered more than 4.5 h to standard of care. h to standard of care.

Thrombolysis 40

Thrombolysis Stroke Strokes Hemorrhage 40

Stroke Journal

JANUARY 4, 2024

BACKGROUND:The effectiveness of intravenous thrombolysis (IVT) before endovascular treatment (EVT) has been investigated in randomized trials and meta-analyses. Primary outcome was a shift toward better functional outcome on the modified Rankin Scale at 90 days. Stroke, Ahead of Print.

Thrombolysis 40

Thrombolysis Circulation Hemorrhage Ischemia 40

Stroke Journal

JANUARY 30, 2025

The primary efficacy outcome was good 3-month functional outcome, defined as a modified Rankin scale (mRS) 0-2. The primary efficacy outcome was good 3-month functional outcome, defined as a modified Rankin scale (mRS) 0-2. Safety outcomes were any intracerebral hemorrhage (ICH) and symptomatic ICH (sICH) at 24-36hrs.

Thrombolysis 40

Thrombolysis Outcomes Stroke Strokes 40

Stroke Journal

FEBRUARY 1, 2024

We evaluated the risk of hemorrhage associated with newer, more potent antiplatelet medications and dual antiplatelet regimens among patients treated with intravenous tissue plasminogen activator (IV-tPA).Methods:Using The primary outcome of interest was symptomatic intracranial hemorrhage (sICH) within 36 hours of tPA administration.

Hemorrhage 40

Hemorrhage Thrombolysis Stroke Strokes 40

Stroke Journal

JANUARY 30, 2025

Introduction:Current guidelines suggest using intravenous thrombolysis (IVT) for patients experiencing acute ischemic stroke within 4.5 The efficacy outcomes were the 3-months modified Rankin Scale (mRS) 0-1 or return to baseline mRS and an improvement of two points in the 24hrs-NIHSS or a 24hrs-NIHSS of 0. hours of symptom onset.

Thrombolysis 40

Thrombolysis Stroke Strokes Education 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Intracerebral hemorrhage (ICH) is a main complication of IVT, with prevalence reported around 3.2% Additionally, extravasation of contrast was seen within the left basal ganglia region, concerning for hemorrhagic transformation from IV‐tPA. Left ICA stenting was not completed secondary to hemorrhagic transformation.

Hemorrhage 40

Hemorrhage Thrombolysis Stroke Strokes 40

Stroke Journal

JANUARY 30, 2025

Introduction:The tenecteplase versus standard of care for minor ischemic stroke with proven occlusion (TEMPO-2) trial showed that patients presenting with minor deficits up to 12 h do not benefit from intravenous thrombolysis. h, if they were not eligible for standard-of-care thrombolysis. mg/kg) or non-thrombolytic standard of care.

Thrombolysis 40

Thrombolysis Stroke Strokes Outcomes 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

However, there is conflicting data in terms of intracranial hemorrhage risk.Objective: We are reporting the rate of symptomatic intracranial hemorrhage(sICH) in TNK and tPA treated stroke populations across two large hospital systems.MethodsDesign: Retrospective cohort observational study. A total of 431 patients were included.

Hemorrhage 40

Hemorrhage Thrombolysis Stroke Strokes 40

Stroke Journal

FEBRUARY 1, 2024

Median time from the onset of visual change to thrombolysis was 6.0 [4.5-10.5] One (5.3%) patient had intra-ocular hemorrhage post thrombolysis.Conclusion:Compared to central retinal artery occlusion, patient with branched retinal occlusion have better visual recovery following IA or IV thrombolysis. VA improvement of ≥0.1

Thrombolysis 40

Thrombolysis Outcomes Hemorrhage Stroke 40

Stroke Journal

JANUARY 30, 2025

The primary outcome was 3-month functional outcome by modified Rankin scale (mRS). Stroke, Volume 56, Issue Suppl_1 , Page ATP20-ATP20, February 1, 2025. Additionally, 213 patients (18.9%) experienced END.

Thrombolysis 40

Thrombolysis Stroke Strokes Risk Factors 40

Stroke Journal

JANUARY 30, 2025

The effectiveness and safety of intravenous thrombolysis (IVT) for acute ischemic stroke in these cases, particularly those involving large vessel occlusions, are debated. However, IVT was associated with a significantly higher odds of good functional outcome at 90-days (aOR, 1.53 [95% CI, 1.14-2.05])

Thrombolysis 40

Thrombolysis Stroke Strokes Hemorrhage 40

Stroke Journal

JANUARY 30, 2025

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.

Thrombolysis 40

Thrombolysis Stroke Strokes Stent 40

Stroke Journal

FEBRUARY 1, 2024

The role of adjunctive intravenous thrombolysis, such as intravenous tissue plasminogen activator (IVtPA), with MT remains unclear, especially for medium vessel occlusion (MeVO). In univariable regression, all outcomes were comparable between the two groups, except for higher mRS 0-2 rates in the MT+IVtPA group.

Thrombolysis 40

Thrombolysis Academic Hemorrhage Outcomes 40

Stroke Journal

FEBRUARY 1, 2024

We defined two binary outcomes: (1) functional clinical outcome (modified Rankin Scale 0-2) and (2) early symptomatic intracerebral hemorrhage (sICH). 4.14, p=0.9502), but it was associated with a functional clinical outcome at 90 days (OR 3.39, 95% CI 1.11-10.43, 10.43, p=0.0325).Conclusions:The

Stents 40

Stents Stent Thrombolysis Angioplasty 40

Stroke Journal

FEBRUARY 1, 2024

Recent landmark trials BEST-MSU and B_PROUD have proven that MSUs facilitate quicker thrombolysis times and improved functional outcomes at 90 days when compared to conventional emergency medical services (EMS) for acute ischemic stroke patients. Faster time metrics convey a hypothetical benefit towards improved patient outcomes.

Hemorrhage 40

Hemorrhage Blood Pressure Stroke Strokes 40

Stroke Journal

JANUARY 30, 2025

Background and Aims:Previous studies indicated the usual dose heparin(5000 IU bolus followed by 500~1250 IU/h) during mechanical thrombectomy(MT) is associated with an increased risk of hemorrhagic conversion without beneficial effect. This trend also seemed to be seen in patients who did not undergo intravenous thrombolysis group.

Hemorrhage 40

Hemorrhage Thrombolysis Stroke Strokes 40

Stroke Journal

DECEMBER 21, 2023

BACKGROUND:The association of COVID-19 with higher bleeding risk and worse outcomes in acute ischemic stroke (AIS) undergoing revascularization may be related to the presence of infection symptoms. The magnitude of this effect is more pronounced in symptomatic infections, which also present less favorable recanalization outcomes.

COVID-19 40

COVID-19 Outcomes Stroke Strokes 40

Stroke Journal

JANUARY 30, 2025

We studied the impact of intravenous thrombolysis (IVT) on the outcomes of EVT in those patients.Methods:We conducted a meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and the Cochrane Handbook of Systematic Reviews and Interventions.

Thrombolysis 40

Thrombolysis Hemorrhage Outcomes Stroke 40

Stroke Journal

JANUARY 30, 2025

Direct-to-angiography workflow relies on CBCT to exclude intracranial hemorrhage (ICH) to determine treatment eligibility for intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT). Conclusion:CBCT had high specificity for ICH and hemorrhage types.

Hemorrhage 40

Hemorrhage Stroke Strokes Thrombolysis 40

Stroke Journal

JANUARY 30, 2025

Background and objective:Perfusion imaging studies consistently show a substantially increased risk of hemorrhagic transformation (HT) in severely hypoperfused tissue. For this study, we included patients with some degree of recanalization (expanded Thrombolysis in Cerebral Infarct [eTICI] >0) and available baseline CT perfusion.

Hemorrhage 40

Hemorrhage Stroke Strokes Thrombolysis 40

Stroke Journal

JANUARY 30, 2025

Introduction:Current guidelines recommend 24-hours of high-intensity monitoring (HIM) for acute ischemic stroke patients post-intravenous thrombolysis (IVT) due to risk of bleeding complications including symptomatic intracranial hemorrhage (sICH).

Thrombolysis 40

Thrombolysis ICU Stroke Strokes 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Intravenous thrombolysis (IVT) is efficacious treatment of acute ischemic stroke (AIS). Outcomes of interest were symptomatic intracranial hemorrhage (sICH), any ICH, serious systemic bleeding (SSB), and 90-day functional independence (mRS 0-2). Stroke, Volume 55, Issue Suppl_1 , Page A25-A25, February 1, 2024.

Thrombolysis 40

Thrombolysis Stroke Strokes Hemorrhage 40

Stroke: Vascular and Interventional Neurology

JANUARY 3, 2025

BACKGROUNDComorbidity burden may affect the outcome following endovascular thrombectomy (EVT) for mediumvessel occlusions. The primary outcome was a favorable outcome (modified Rankin Scale 02) at 90 days after EVT in relation to comorbidity burden. Stroke: Vascular and Interventional Neurology, Ahead of Print.

Outcomes 40

Outcomes Stroke Strokes Hemorrhage 40

Stroke Journal

DECEMBER 9, 2024

We assessed the correlation of these parameters with infarct expansion, hemorrhagic transformation, and poor outcomes, defined as modified Rankin Scale scores of 4 to 6, at 3 months.RESULTS:A total of 65 cases were analyzed. Cerebral blood flow <45% (r=0.57;P<0.001)

Thrombolysis 68

Thrombolysis Stroke Strokes Hemorrhage 68

Stroke Journal

JANUARY 30, 2025

Introduction:Tenecteplase (TNK) is now an accepted alternative to Alteplase (ALT) for intravenous thrombolysis (IVT) in acute ischemic stroke (AIS). Hemorrhagic transformation (HT), a complication of IVT, is more frequent in acute hyperglycemia and diabetes (DM) and is associated with poor clinical outcomes.

Hemorrhage 40

Hemorrhage Diabetes Stroke Strokes 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Collateral status imaging parameters are associated with predicting hemorrhagic transformation (HT) in acute ischemic stroke caused by large vessel occlusions. Stroke, Volume 55, Issue Suppl_1 , Page ATP146-ATP146, February 1, 2024.

Hemorrhage 40

Hemorrhage Thrombolysis Diabetes Biomarkers 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 21, 2023

The patients with successful recanalization defined as modified Thrombolysis in Cerebral Infarction ≥2b at 5, 6, 7, or more passes were compared with unsuccessful recanalization. Primary outcome was a favorable 90‐day outcome (modified Rankin scale score of 0–2). We also compared procedure time, separated by 30 minutes.

Outcomes 40

Outcomes Stroke Strokes Hemorrhage 40

Stroke Journal

JANUARY 30, 2025

Introduction:Outcomes after thrombolysis with alteplase (tPA) versus tenecteplase (TNK) prior to endovascular thrombectomy (EVT) have not been directly compared in real-world data (RWD). tPA was used exclusively for thrombolysis at one center (n=74), while TNK was used exclusively for thrombolysis at another center (n=130).

Thrombolysis 40

Thrombolysis Hemorrhage Academic Outcomes 40

Stroke Journal

JANUARY 30, 2025

The primary efficacy outcome was favorable functional outcome, defined as modified Rankin Scale (mRS) scores of 0-3 at one year. We also evaluated procedural outcomes, including successful reperfusion, defined as modified Thrombolysis in Cerebral Infarction (mTICI) grade 2b-3, and complete reperfusion, defined as mTICI 3.Results:Among

Circulation 40

Circulation Outcomes Stroke Strokes 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Real-world data showed that less than half of the acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) presenting with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (2-5) achieved favorable outcomes at 90 days after mechanical thrombectomy (MT). was related to 90-day mRS 0-3.

Outcomes 40

Outcomes Stroke Strokes Hemorrhage 40