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Functional Outcome after Mechanical Thrombectomy with or without Previous Thrombolysis

2021-02Journal article Open access
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dc.contributor.authorMachado, M
dc.contributor.authorAlves, M
dc.contributor.authorFior, A
dc.contributor.authorFragata, I
dc.contributor.authorPapoila, AL
dc.contributor.authorReis, J
dc.contributor.authorPaiva Nunes, A
dc.date.accessioned2021-10-06T12:14:48Z
dc.date.available2021-10-06T12:14:48Z
dc.date.issued2021-02
dc.description.abstractIntroduction: Combined intravenous therapy (IVT) and mechanical thrombectomy (MT) is the standard treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO). However, the use of IVT before MT is recently being questioned. Objectives: To compare patients treated with IVT before MT with those treated with MT alone, in a real-world scenario. Methods: Retrospective analysis of AIS patients with LVO of the anterior circulation who underwent MT, with or without previous IVT, between 2016 and 2018. Results: A total of 524 patients were included (347 submitted to IVT+MT; 177 to MT alone). No differences between groups were found except for a higher time from stroke onset to CT and to groin puncture in the MT group (297.5 min vs 115.0 min and 394.0 min vs 250.0 min respectively, p < 0.001). Multivariable analysis showed that age<75 years (OR 2.65, 95% CI 1.71-4.07, p < 0.001), not using antiplatelet therapy (OR 1.93, 95% CI 1.21-3.08, p = 0.006), low prestroke mRS (OR 4.33, 95% CI 1.89-9.89, p < 0.001), initial NIHSS (OR 0.89, 95% CI 0.86-0.93, p < 0.001), absent cerebral edema (OR 7.83, 95% CI 3.31-18.51, p < 0.001), and mTICI 2b/3 (OR 4.56, 95% CI 2.17-9.59, p < 0.001) were independently associated with good outcome (mRS 0-2). Conclusions: Our findings support the idea that IVT before MT does not influence prognosis, in a real-world setting.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Stroke Cerebrovasc Dis. 2021 Feb;30(2):105495.pt_PT
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2020.105495.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3866
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHSJ UCVpt_PT
dc.subjectCHLC CINVpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectAgedpt_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectCombined Modality Therapy
dc.subjectDatabases, Factual
dc.subjectFemale
dc.subjectMiddle Aged
dc.subjectDisability Evaluation
dc.subjectFibrinolytic Agents / administration & dosage*
dc.subjectFibrinolytic Agents / adverse effects
dc.subjectFunctional Status
dc.subjectInfusions, Intravenous
dc.subjectIschemic Stroke / diagnosis
dc.subjectIschemic Stroke / physiopathology
dc.subjectIschemic Stroke / therapy*
dc.subjectRecovery of Function
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectThrombectomy* / adverse effects
dc.subjectThrombolytic Therapy* / adverse effects
dc.subjectTime Factors
dc.subjectTime-to-Treatment
dc.subjectTreatment Outcome
dc.titleFunctional Outcome after Mechanical Thrombectomy with or without Previous Thrombolysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage105495pt_PT
oaire.citation.titleJournal of Stroke and Cerebrovascular Diseasespt_PT
oaire.citation.volume30pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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