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Verfasst von:Demeestere, Jelle [VerfasserIn]   i
 Qureshi, Muhammad M. [VerfasserIn]   i
 Vandewalle, Lieselotte [VerfasserIn]   i
 Wouters, Anke [VerfasserIn]   i
 Strbian, Daniel [VerfasserIn]   i
 Nogueira, Raul G. [VerfasserIn]   i
 Nagel, Simon [VerfasserIn]   i
 Yamagami, Hiroshi [VerfasserIn]   i
 Puetz, Volker [VerfasserIn]   i
 Abdalkader, Mohamad [VerfasserIn]   i
 Haussen, Diogo C. [VerfasserIn]   i
 Mohammaden, Mahmoud H. [VerfasserIn]   i
 Möhlenbruch, Markus Alfred [VerfasserIn]   i
 Olivé-Gadea, Marta [VerfasserIn]   i
 Winzer, Simon [VerfasserIn]   i
 Ribo, Marc [VerfasserIn]   i
 Michel, Patrik [VerfasserIn]   i
 Marto, João Pedro [VerfasserIn]   i
 Tanaka, Kanta [VerfasserIn]   i
 Yoshimura, Shinichi [VerfasserIn]   i
 Martinez-Majander, Nicolas [VerfasserIn]   i
 Caparros, Francois [VerfasserIn]   i
 Henon, Hilde [VerfasserIn]   i
 Tomppo, Liisa [VerfasserIn]   i
 Dusart, Anne [VerfasserIn]   i
 Bellante, Flavio [VerfasserIn]   i
 Ramos, João Nuno [VerfasserIn]   i
 Jesser, Jessica [VerfasserIn]   i
 Sheth, Sunil A. [VerfasserIn]   i
 Ortega-Gutiérrez, Santiago [VerfasserIn]   i
 Siegler, James E. [VerfasserIn]   i
 Nannoni, Stefania [VerfasserIn]   i
 Kaesmacher, Johannes [VerfasserIn]   i
 Dobrocky, Tomas [VerfasserIn]   i
 Salazar-Marioni, Sergio [VerfasserIn]   i
 Farooqui, Mudassir [VerfasserIn]   i
 Virtanen, Pekka [VerfasserIn]   i
 Ventura, Rita [VerfasserIn]   i
 Zaidi, Syed F. [VerfasserIn]   i
 Castonguay, Alicia C. [VerfasserIn]   i
 Uchida, Kazutaka [VerfasserIn]   i
 Puri, Ajit S. [VerfasserIn]   i
 Sakai, Nobuyuki [VerfasserIn]   i
 Toyoda, Kazunori [VerfasserIn]   i
 Farzin, Behzad [VerfasserIn]   i
 Masoud, Hesham E. [VerfasserIn]   i
 Klein, Piers [VerfasserIn]   i
 Bui, Jenny [VerfasserIn]   i
 Rizzo, Federica [VerfasserIn]   i
 Kaiser, Daniel P.O. [VerfasserIn]   i
 Desfontaines, Philippe [VerfasserIn]   i
 Strambo, Davide [VerfasserIn]   i
 Cordonnier, Charlotte [VerfasserIn]   i
 Lin, Eugene [VerfasserIn]   i
 Ringleb, Peter A. [VerfasserIn]   i
 Roy, Daniel [VerfasserIn]   i
 Zaidat, Osama O. [VerfasserIn]   i
 Fischer, Urs [VerfasserIn]   i
 Raymond, Jean [VerfasserIn]   i
 Lemmens, Robin [VerfasserIn]   i
 Nguyen, Thanh N. [VerfasserIn]   i
Titel:Outcomes of bridging intravenous thrombolysis versus endovascular therapy alone in late-window acute ischemic stroke
Verf.angabe:Jelle Demeestere, MD, PhD; Muhammad M. Qureshi, MBBS, MPH; Lieselotte Vandewalle, MD; Anke Wouters, MD, PhD; Daniel Strbian, MD, PhD, MSc; Raul G. Nogueira, MD; Simon Nagel, MD; Hiroshi Yamagami, MD, PhD; Volker Puetz, MD; Mohamad Abdalkader, MD; Diogo C. Haussen, MD; Mahmoud H. Mohammaden, MD; Markus A. Möhlenbruch, MD; Marta Olivé-Gadea, MD; Simon Winzer, MD; Marc Ribo, MD, PhD; Patrik Michel, MD; João Pedro Marto, MD; Kanta Tanaka, MD; Shinichi Yoshimura, MD, PhD; Nicolas Martinez-Majander, MD, PhD; Francois Caparros, MD; Hilde Henon, MD, PhD; Liisa Tomppo, MD, PhD; Anne Dusart, MD; Flavio Bellante, MD; João Nuno Ramos, MD; Jessica Jesser, MD; Sunil A. Sheth, MD; Santiago Ortega-Gutiérrez, MD; James E. Siegler, MD; Stefania Nannoni, MD; Johannes Kaesmacher, MD, PhD; Tomas Dobrocky, MD; Sergio Salazar-Marioni, MD; Mudassir Farooqui, MD; Pekka Virtanen, MD; Rita Ventura, MD; Syed F. Zaidi, MD; Alicia C. Castonguay, PhD; Kazutaka Uchida, MD, PhD; Ajit S. Puri, MD; Nobuyuki Sakai, MD, PhD; Kazunori Toyoda, MD; Behzad Farzin, MD; Hesham E. Masoud, MD; Piers Klein, MA; Jenny Bui, MSPAS; Federica Rizzo, MD; Daniel P.O. Kaiser, MD; Philippe Desfontaines, MD; Davide Strambo, MD; Charlotte Cordonnier, MD, PhD; Eugene Lin, MD; Peter A. Ringleb, MD; Daniel Roy, MD; Osama O. Zaidat, MD, MSc; Urs Fischer, MD, MS; Jean Raymond, MD; Robin Lemmens, MD, PhD; Thanh N. Nguyen, MD
E-Jahr:2024
Jahr:15 May 2024
Umfang:9 S.
Illustrationen:Illustrationen
Fussnoten:Gesehen am 31.01.2025
Titel Quelle:Enthalten in: Stroke
Ort Quelle:New York, NY : Association, 1970
Jahr Quelle:2024
Band/Heft Quelle:55(2024), 7, Seite 1767-1775
ISSN Quelle:1524-4628
Abstract:BACKGROUND: - Studies comparing bridging intravenous thrombolysis (IVT) with direct endovascular therapy (EVT) in patients with acute ischemic stroke who present late are limited. We aimed to compare the clinical outcomes and safety of bridging IVT in patients with acute ischemic stroke due to anterior circulation large vessel occlusion who underwent EVT 6 to 24 hours after time last known well. - METHODS: - We enrolled patients with anterior circulation large vessel occlusion stroke and a National Institutes of Health Stroke Scale score of ≥6 from 20 centers across 10 countries in the multicenter retrospective CLEAR study (CT for Late Endovascular Reperfusion) between January 2014 and May 2022. We used inverse probability of treatment weighting modeling adjusted for clinical and imaging confounders to compare functional outcomes, reperfusion success, symptomatic intracranial hemorrhage, and mortality between EVT patients with and without prior IVT. - RESULTS: - Of 5098 patients screened for eligibility, we included 2749 patients, of whom 549 received bridging IVT before EVT. The timing of IVT was not recorded. Witnessed stroke onset and transfer rates were higher in the bridging IVT group (25% versus 12% and 77% versus 55%, respectively, P value for both <0.0001), and time intervals between stroke onset and treatment were shorter (time last known well—start of EVT median 560 minutes [interquartile range, 432-791] versus 724 minutes [interquartile range, 544-912]; P<0.0001). After adjustment for confounders, there was no difference in functional outcome at 3 months (adjusted common odds ratio for modified Rankin Scale shift, 1.03 [95% CI, 0.89-1.19]; P=0.72) or successful reperfusion (adjusted odds ratio, 1.19 [95% CI, 0.81-1.75]; P=0.39). There were no safety concerns associated with bridging IVT versus direct EVT (symptomatic intracranial hemorrhage: adjusted odds ratio, 0.75 [95% CI, 0.38-1.48]; P=0.40; mortality: adjusted odds ratio, 1.14 [95% CI, 0.89-1.46]; P=0.31). Results were unchanged when the analysis was limited to patients who received IVT >6 hours after last known well. - CONCLUSIONS: - In patients with an anterior circulation large vessel occlusion stroke who underwent EVT 6 to 24 hours from last known well, bridging IVT was not associated with a difference in outcomes compared with direct EVT. - REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT04096248.
DOI:doi:10.1161/STROKEAHA.124.046495
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

kostenfrei: Volltext: https://doi.org/10.1161/STROKEAHA.124.046495
 kostenfrei: Volltext: https://www.ahajournals.org/doi/10.1161/STROKEAHA.124.046495
 DOI: https://doi.org/10.1161/STROKEAHA.124.046495
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1916090362
Verknüpfungen:→ Zeitschrift

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