Interesting stuff that only our doctors should be concerned about. I dislike that the outcome measures were not objective, like looking at CT/MRI scans to measure volume of dead/dying areas.
I have no clue what I had. You could ask your doctor why they chose what they did for you. They should have a research-backed answer.
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0116120
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Qing-feng Ma,
-
Chang-biao Chu,
-
Hai-qing Song
mail
- Published: January 08, 2015
- DOI: 10.1371/journal.pone.0116120
Abstract
Background
Reperfusion
following ischemic stroke can be attained by either intravenous
thrombolysis (IVT) or intra-arterial thrombolysis (IAT). Only a limited
number of randomized prospective studies have compared the efficacy and
safety of IVT and IAT. This meta-analysis investigated possible clinical
benefits of IAT relative to IVT in patients with acute ischemic stroke.
Methods
We
searched the PubMed, Cochrane, and Google Scholar databases through
October 2013 for manuscripts that describe the findings of randomized
controlled or prospective studies that evaluated the outcomes of
patients with ischemic stroke who were treated with IVT or IAT.
The
clinical outcome measures were score on the modified Rankin scale (mRS)
and mortality at 90 days. A favorable outcome was defined as an mRS
score of 0 to 2.
Results
For
the mRS, the combined odds ratio (OR) of 3.28 (95% confidence interval
(CI), 1.91 to 5.65, P < 0.001) indicated that patients who received
IAT had a significantly higher chance for a favorable outcome than did
those who received IVT. For mortality, the OR indicated that IAT therapy
significantly reduced the proportion of patients who died within 90
days of the procedure (combined OR, 0.40; 95%CI, 0.17 to 0.92; P =
0.032).
Conclusion
This
meta-analysis determined that IAT conferred a significantly greater
probability of achieving a favorable outcome compared with IVT. There
was also a significant difference in mortality rates between IAT and
IVT. The studies included in this analysis were small and heterogeneous;
therefore, larger randomized prospective clinical studies are necessary
to further investigate this issue.
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