More ‘Excellent’ Outcomes With Intra-Arterial Alteplase After Successful Reperfusion in Acute Stroke

 Successful reperfusion DOES NOT MEAN 100% RECOVERY! So, complete fucking failure! 100% recovery is the only goal in stroke! Survivors want nothing less, don't try the tyranny of low expectations on them!

More ‘Excellent’ Outcomes With Intra-Arterial Alteplase After Successful Reperfusion in Acute Stroke

Treatment with intra-arterial alteplase after successful endovascular reperfusion resulted in a higher likelihood of excellent outcomes at 90 days among patients with acute, anterior-circulation, large-vessel occlusion stroke. Researchers published the findings in JAMA.

“The incidence of all-cause mortality and any intracranial hemorrhage was higher in patients who received intra-arterial alteplase, although these differences were not statistically significant,” wrote corresponding authors Yamei Tang, MD, PhD, of Sun Yat-sen University, Guangzhou, China, and Raul G. Nogueira, MD, of the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, and study coauthors.

The PEARL trial recruited 324 patients with anterior-circulation, large-vessel occlusion stroke who achieved successful reperfusion by mechanical thrombectomy between August 1, 2023, and October 16, 2024, at 28 hospitals in China. Among the patients, 164 were randomized to intra-arterial alteplase treatment with 0.225 mg/kg and 160 to standard treatment that adhered to the latest clinical guidelines. The study’s primary efficacy outcome was the proportion of patients with an excellent outcome, defined as a modified Rankin Scale score of 0 or 1, at 90 days.

>>NEWS: Added Levodopa Does Not Significantly Benefit Stroke Recovery

Really? What about this? 

Ask your doctor what they are using levodopa for in your recovery.  No knowledge is grounds for firing.

Early Promise For Stroke Patients Given - levodopa  back to Sept. 2001.

• levodopa (14 posts to May 2012)

According to the results, 44.8% of patients in the intra-arterial alteplase group vs 30.2% in the standard treatment group achieved an excellent outcome at 90 days, for an adjusted risk ratio of 1.45. Rates of symptomatic intracranial hemorrhage within 36 hours were 4.3% with intra-arterial alteplase vs 5.0% with standard treatment group, for an 0.85 adjusted risk ratio.

However, the intra-arterial alteplase group had higher rates of 90-day all-cause mortality and any intracranial hemorrhage within 36 hours. All-cause mortality within 90 days was 17.1% with intra-arterial alteplase vs 11.3% with standard treatment, for an adjusted hazard ratio of 1.60. Any intracranial hemorrhage within 36 hours was 32.9% with intra-arterial alteplase group vs 26.9% with standard treatment, for an adjusted risk ratio of 1.22.

“The evidence from the current trial, the CHOICE trial, and the ANGEL-TNK trial suggests a potential benefit of adjunctive intra-arterial thrombolysis. Meta-analyses, including neutral data from the POST-UK and POST-TNK trials, have also shown a favorable trend in functional outcomes associated with intra-arterial thrombolysis after mechanical thrombectomy,” researchers wrote. “However, the current evidence remains insufficient to fully support intra-arterial thrombolysis after mechanical thrombectomy in clinical practice.”