But they don't tell you the most important result. How many got 100% recovered? The mentors and senior researchers who allow this bad research need to be fired. Using the subjective Rankin scale doesn't help.
Analysis From the North American Solitaire Stent-Retriever Acute Stroke Registry
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Abstract
Background and Purpose—
Mechanical
thrombectomy (MT) devices have led to improved reperfusion and clinical
outcomes in acute ischemic stroke patients with emergent large vessel
occlusions; however, less than one-third of patients achieve complete
reperfusion. Use of intraarterial thrombolysis in the context of MT may
provide an opportunity to enhance these results. Here, we evaluate the
use of intraarterial rtPA (recombinant tissue-type plasminogen
activator) as rescue therapy (RT) after failed MT in the North American
Solitaire Stent-Retriever Acute Stroke registry.
Methods—
The
North American Solitaire Stent-Retriever Acute Stroke registry
recruited sites within North America to submit data on acute ischemic
stroke patients treated with the Solitaire device. After restricting the
population of 354 patients to use of RT and anterior emergent large
vessel occlusions, we compared patients who were treated with and
without intraarterial rtPA after failed MT.
Results—
A
total of 37 and 44 patients was in the intraarterial rtPA RT and the no
intraarterial rtPA RT groups, respectively. Revascularization success
(modified Thrombolysis in Cerebral Infarction ≥2b) was achieved in more
intraarterial rtPA RT patients (61.2% versus 46.6%; P=0.13) with faster times to recanalization (100±85 versus 164±235 minutes; P=0.36) but was not statistically significant. The rate of symptomatic intracranial hemorrhage (13.9% versus 6.8%; P=0.29) and mortality (42.9% versus 44.7%; P=0.87)
were similar between the groups. Good functional outcome (modified
Rankin Scale score of ≤2) was numerically higher in intraarterial rtPA
patients (22.9% versus 18.4%; P=0.64). Further restriction of the
RT population to M1 occlusions only and time of onset to groin puncture
≤8 hours, resulted in significantly higher successful revascularization
rates in the intraarterial rtPA RT cohort (77.8% versus 38.9%; P=0.02).
Conclusions—
Intraarterial
rtPA as RT demonstrated a similar safety and clinical outcome profile,
with higher reperfusion rates achieved in patients with M1 occlusions.
Prospective studies are needed to delineate the role of intraarterial
thrombolysis in MT.
Footnotes
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