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Recent trials have shown that thrombectomy alone is comparable to bridging in patients with anterior circulation large vessel occlusion eligible for intravenous alteplase and endovascular thrombectomy
.
In order to explore whether the occlusion site would change the effect of intravenous alteplase before thrombectomy , Jianmin Liu's team from the Department of Neurosurgery of Shanghai Changhai Hospital continued to analyze in the DIRECT-MT trial, and the results were published in the journal Stroke .Recent trials have shown that thrombectomy alone is comparable to bridging in patients with anterior circulation large vessel occlusion eligible for intravenous alteplase and endovascular thrombectomy
Independent predictors of symptomatic intracranial hemorrhage were baseline NIHSS score and glucose level on admission
In this phase of the study, of 658 randomized patients, 640 patients with baseline occlusion site information were included
.
The primary outcome was the modified Rankin Scale (mRS) score at 90 days
The results showed that the overall adjusted common odds ratio of thrombectomy alone was 1.
08 (95% CI, 0.
In subgroups based on occlusion location, the following adjusted common odds were found: 0.
Differences in mRS scores between the two groups of patients
No treatment interaction was observed for different occlusion sites with respect to dichotomous mRS distribution and successful reperfusion (cerebral infarction expansion thrombolysis score ≥2b) before thrombectomy
.
There was little difference in the rate of symptomatic bleeding between occlusion sites (internal carotid artery occlusion: 7.
There was little difference in the rate of symptomatic bleeding between occlusion sites (internal carotid artery occlusion: 7.
In the prespecified subgroup of this randomized trial, the location of the occlusion did not inform the decision to select intravenous alteplase in patients eligible for endovascular therapy
Effect of Occlusion Site on the Safety and Efficacy of Intravenous Alteplase Before Endovascular Thrombectomy: A Prespecified Subgroup Analysis of DIRECT-MT.
Effect of Occlusion Site on the Safety and Efficacy of Intravenous Alteplase Before Endovascular Thrombectomy: A Prespecified Subgroup Analysis of DIRECT-MT.
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