JAMA: Treatment of patients with acute large vascular thrombosis stroke - thrombosis joint hydrants vs simple mechanical thrombosis (SKIP study)

Current guidelines recommend that for patients with large vascular thrombosis stroke within 4.5 hours of the onset of symptoms, a 0.9 mg/Kg body weight of atipase thrombosis is performed first, and then mechanical hydrants.
recent years, some studies have found that patients with large vascular thrombosis stroke directly after mechanical hydration of the patient's 90-day prognosis is equivalent to the post-thrombosis embolism.
recently conducted a large-scale non-inferior control study to examine the effects of simple thrombosis and venous thrombosis combined mechanical hydrants on patient prognosis.
study, conducted in Japan from January 1, 2017 to July 31, 2019, involved 204 patients with acute ishemotic stroke caused by large vascular thrombosis, 101 of whom received simple mechanical thrombosis and 103 who received a mechanical thrombosis (atipase dose 0.6 mg/kg dose).
endpoint of the study was a good functional prognosmation, defining Rankin's score of 0-2, and the key secondary endpoints included a 90-day mortality rate and any cerebral hemorrhage and symptomatic cerebral hemorrhage within 36 hours.
patients were 74 years old, 62.7 percent were men, the average NIHSS score was 18, and all patients completed the trial.
60 patients in the simple mechanical thrombosis group (59.4%) had good prognosis, while 59 cases (57.3%) in the combined venous thrombosis-mechanical thrombosis group had no significant difference in the proportion of patients with good functional prognosis (difference: 2.1%). There were no significant differences in 10 of the 7 secondary efficacy endpoints and 4 safety endpoints between the
groups, including 90 days mortality (8 cases (7.9 per cent) vs 9 cases (8.7 per cent); 33.7% vs 52 cases (50.5%); difference: -16.8%; Advantage ratio: 0.50), no significant difference in symptomatic cerebral hemorrhage rate between groups (6 cases of 5.9%) vs8 cases (7.7%); difference: -1.8%; ratio ratio: 0.75%)
study concluded that in patients with acute large vascular reforestation stroke, the proportion of functional prognosis of patients with mechanical thrombosis alone was comparable to that of mechanical thrombosis after venous thrombosis, but the occurrence of cerebral hemorrhage in the individual thrombosis group was lower.