Imperial College London
Portrait Picture

Dr Joseph Kwan MD FRCP FESO FAHA

Faculty of Medicine, Department of Brain Sciences

Honorary Senior Lecturer
 
 
 
//

Contact

 

joseph.kwan

 
 
//

Location

 

Sir Alexander Fleming BuildingSouth Kensington Campus

//

Summary

 

Publications

Citation

BibTex format

@article{D'Anna:2023:10.3390/jcm12031150,
author = {D'Anna, L},
doi = {10.3390/jcm12031150},
journal = {Journal of Clinical Medicine},
pages = {1--9},
title = {Endovascular thrombectomy with or without intravenous thrombolysis for anterior circulation large vessel occlusion in the Imperial College London Thrombectomy Registry},
url = {http://dx.doi.org/10.3390/jcm12031150},
volume = {12},
year = {2023}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background and purpose. Mechanical thrombectomy (MT) is the standard of care for eligible patients with a large vessel occlusion (LVO) acute ischemic stroke. Among patients undergoing MT there has been uncertainty regarding the role of intravenous thrombolysis (IVT) and previous trials have yielded conflicting results regarding clinical outcomes. We aim to investigate clinical, reperfusion outcomes and safety of MT with or without IVT for ischemic stroke due to anterior circulation LVO. Materials and Methods. This observational, prospective, single-centre study included consecutive patients with acute LVO ischemic stroke of the anterior circulation. The primary outcomes were the rate of in-hospital mortality, symptomatic intracranial haemorrhage and functional independence (mRS 0–2 at 90 days). Results. We enrolled a total of 577 consecutive patients: 161 (27.9%) were treated with MT alone while 416 (72.1%) underwent IVT and MT. Patients with MT who were treated with IVT had lower rates of in-hospital mortality (p = 0.037), higher TICI reperfusion grades (p = 0.007), similar rates of symptomatic intracranial haemorrhage (p = 0.317) and a higher percentage of functional independence mRS (0–2) at 90 days (p = 0.022). Bridging IVT with MT compared to MT alone was independently associated with a favorable post-intervention TICI score (>2b) (OR, 1.716; 95% CI, 1.076–2.735, p = 0.023). Conclusions. Our findings suggest that combined treatment with MT and IVT is safe and results in increased reperfusion rates as compared to MT alone.
AU  - D'Anna,L
DO  - 10.3390/jcm12031150
EP  - 9
PY  - 2023///
SN  - 2077-0383
SP  - 1
TI  - Endovascular thrombectomy with or without intravenous thrombolysis for anterior circulation large vessel occlusion in the Imperial College London Thrombectomy Registry
T2  - Journal of Clinical Medicine
UR  - http://dx.doi.org/10.3390/jcm12031150
UR  - https://www.mdpi.com/2077-0383/12/3/1150
UR  - http://hdl.handle.net/10044/1/102835
VL  - 12
ER  -
Download