Outcomes of endovascular treatment alone or with intravenous alteplase in acute ischemic stroke Patients: A retrospective cohort study

IF 1.3 Q4 CLINICAL NEUROLOGY

Brain Hemorrhages Pub Date : 2024-02-01 DOI:10.1016/j.hest.2023.09.003

Mahmoud Galal Ahmed , Nour Shaheen , Ahmed Shaheen , Mostafa Meshref , Abdulqadir J. Nashwan , Nourelhuda Ahmed Nassar , Khaled Sobh

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Abstract

Objective

The aim of this study is to compare the clinical outcomes, safety, and workflow of patients who underwent endovascular treatment (EVT) alone or in combination with intravenous thrombolysis (IVT), against a control group who only received EVT.

Methods

A retrospective analysis from May 2018 to September 2021 was conducted on 50 patients exhibiting acute ischemic stroke symptoms. 35 patients received EVT alone, while 15 received EVT and IVT. The data collected included demographic information, comorbid diseases, symptom onset time, duration from admission to puncture, and clinical outcomes via the National Institutes of Health Stroke Scale score and modified Rankin scale score at admission and 90 days post-procedure.

Results

No significant differences were observed in the 90-day modified Rankin scale scores between the EVT + IVT and EVT alone groups (p > 0.05). NIHSS scores were also similar between the groups (p > 0.05). The EVT + IVT group demonstrated higher intracranial hemorrhage and symptomatic intracranial hemorrhage rates than the EVT alone group, but the difference became insignificant after adjusting for age and sex (p < 0.01). Mortality outcomes showed no significant difference (p > 0.05).

Conclusion

The combined EVT and IVT treatment's safety outcomes are not inferior, aligning with existing literature.

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急性缺血性脑卒中患者单纯血管内治疗或静脉注射阿替普酶的疗效：回顾性队列研究

目的本研究旨在比较单独接受血管内治疗（EVT）或与静脉溶栓（IVT）联合治疗的患者与仅接受 EVT 的对照组的临床结果、安全性和工作流程。方法从 2018 年 5 月到 2021 年 9 月，对 50 名出现急性缺血性卒中症状的患者进行了回顾性分析。35名患者仅接受了EVT，15名患者接受了EVT和IVT。收集的数据包括人口统计学信息、合并疾病、症状发作时间、从入院到穿刺的持续时间，以及入院时和术后90天通过美国国立卫生研究院卒中量表评分和改良Rankin量表评分得出的临床结果。结果在EVT + IVT组和单纯EVT组之间，90天改良Rankin量表评分未观察到显著差异（p >0.05）。两组的 NIHSS 评分也相似（p > 0.05）。EVT+IVT组的颅内出血率和无症状颅内出血率高于单纯EVT组，但在调整年龄和性别后，差异变得不显著（p <0.01）。结论 EVT 和 IVT 联合治疗的安全性并不差，与现有文献一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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