JAMA: Effect of in-vascular therapy on the 90-day functional prognosis of pre-circulating large vascular thrombosis stroke patients after in vitro therapy vs thrombosis

Several studies have confirmed that intravascular treatment after venous thrombosis (IVT) in stroke patients with pre-circulating large vascular thrombosis can maximize the benefits to patients.
IVT has advantages over intracvascular treatment, but there are also certain risks: some patients receive IVT can be exempted from intracvascular treatment, and IVT can promote intracvascular refill, promote the dissolution of downstream micro-embolism, improve the far-end microcirculation;
recently, researchers examined patients with travascular reforestation stroke, compared with intravenous thrombosis combined with intravascular therapy, the effect of intravascular treatment on the prognosis of patients.
the study was conducted in 33 stroke centers in China and was a multi-center, randomized, non-inefficient trial.
234 adult patients participated, patients for near-end front circulatory intracranial thrombosis stroke, symptoms appeared within 4.5 hours of treatment, and follow-up 90 days, of which 116 people received simple intravascular thrombosis treatment, 118 people received atipase venous thrombosis after vascular thrombosis.
of the study was the proportion of patients with 90-day prognostic independence, defined as RanKin score 0-2, and non-poor performance boundary of -10%.
the trial was terminated early due to efficacy factors.
all 234 patients (with an average age of 68 years; 102 women (43.6 per cent)) completed the trial.
In the 90-day follow-up, 63 patients (54.3%) in the vascular thrombosis group were assessed to have functional prognosis independence, while 55 patients (46.6%) in the combined treatment group achieved functional independence (difference: 7.7%) in the 90-day follow-up, reaching the non-inferior endpoint. there was no significant difference between
groups in symptomatic cerebral hemorrhage (6.1% vs 6.8%; difference: -0.8%) and 90-day mortality (17.2% vs17.8%; difference: -0.5%).
the study concluded that for patients with ischemic stroke caused by near-end pre-circulatory cysts within 4.5 hours of onset, the 90-day functional prognosis independent rate achieved by intravascular therapy alone was comparable to that of combined therapy.