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Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization

Standard

Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization. / Broocks, Gabriel; Meyer, Lukas; Ruppert, Celine; Haupt, Wolfgang; Faizy, Tobias D; Van Horn, Noel; Bechstein, Matthias; Kniep, Helge; Elsayed, Sarah; Kemmling, Andre; Barow, Ewgenia; Fiehler, Jens; Hanning, Uta.

in: J CLIN MED, Jahrgang 11, Nr. 6, 1565, 12.03.2022.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Broocks, G, Meyer, L, Ruppert, C, Haupt, W, Faizy, TD, Van Horn, N, Bechstein, M, Kniep, H, Elsayed, S, Kemmling, A, Barow, E, Fiehler, J & Hanning, U 2022, 'Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization', J CLIN MED, Jg. 11, Nr. 6, 1565. https://doi.org/10.3390/jcm11061565

APA

Broocks, G., Meyer, L., Ruppert, C., Haupt, W., Faizy, T. D., Van Horn, N., Bechstein, M., Kniep, H., Elsayed, S., Kemmling, A., Barow, E., Fiehler, J., & Hanning, U. (2022). Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization. J CLIN MED, 11(6), [1565]. https://doi.org/10.3390/jcm11061565

Vancouver

Broocks G, Meyer L, Ruppert C, Haupt W, Faizy TD, Van Horn N et al. Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization. J CLIN MED. 2022 Mär 12;11(6). 1565. https://doi.org/10.3390/jcm11061565

Bibtex

@article{1a78d88bbbe24cf095fc517e7b72cd5b,
title = "Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization",
abstract = "Intravenous thrombolytic therapy with alteplase (IVT) is a standard of care in ischemic stroke, while recent trials investigating direct endovascular thrombectomy (EVT) approaches showed conflicting results. Yet, the effect of IVT on secondary injury volumes in patients with complete recanalization has not been analyzed. We hypothesized that IVT is associated with worse functional outcome and aggravated secondary injury volumes when administered to patients who subsequently attained complete reperfusion after EVT. Anterior circulation ischemic stroke patients with complete reperfusion after thrombectomy defined as thrombolysis in cerebral infarctions (TICI) scale 3 after thrombectomy admitted between January 2013-January 2021 were analyzed. Primary endpoints were the proportion of patients with functional independence defined as modified Rankin Scale (mRS) score 0-2 at day 90, and secondary injury volumes: Edema volume in follow-up imaging measured using quantitative net water uptake (NWU), and the rate of symptomatic intracerebral hemorrhage (sICH). A total of 219 patients were included and 128 (58%) patients received bridging IVT before thrombectomy. The proportion of patients with functional independence was 28% for patients with bridging IVT, and 34% for patients with direct thrombectomy (p = 0.35). The rate of sICH was significantly higher after bridging IVT (20% versus 7.7%, p = 0.01). Multivariable logistic and linear regression analysis confirmed the independent association of bridging IVT with sICH (aOR: 2.78, 95% CI: 1.02-7.56, p = 0.046), and edema volume (aOR: 8.70, 95% CI: 2.57-14.85, p = 0.006). Bridging IVT was associated with increased edema volume and risk for sICH as secondary injury volumes. The results of this study encourage direct EVT approaches, particularly in patients with higher likelihood of successful EVT.",
author = "Gabriel Broocks and Lukas Meyer and Celine Ruppert and Wolfgang Haupt and Faizy, {Tobias D} and {Van Horn}, Noel and Matthias Bechstein and Helge Kniep and Sarah Elsayed and Andre Kemmling and Ewgenia Barow and Jens Fiehler and Uta Hanning",
year = "2022",
month = mar,
day = "12",
doi = "10.3390/jcm11061565",
language = "English",
volume = "11",
journal = "J CLIN MED",
issn = "2077-0383",
publisher = "MDPI AG",
number = "6",

}

RIS

TY - JOUR

T1 - Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization

AU - Broocks, Gabriel

AU - Meyer, Lukas

AU - Ruppert, Celine

AU - Haupt, Wolfgang

AU - Faizy, Tobias D

AU - Van Horn, Noel

AU - Bechstein, Matthias

AU - Kniep, Helge

AU - Elsayed, Sarah

AU - Kemmling, Andre

AU - Barow, Ewgenia

AU - Fiehler, Jens

AU - Hanning, Uta

PY - 2022/3/12

Y1 - 2022/3/12

N2 - Intravenous thrombolytic therapy with alteplase (IVT) is a standard of care in ischemic stroke, while recent trials investigating direct endovascular thrombectomy (EVT) approaches showed conflicting results. Yet, the effect of IVT on secondary injury volumes in patients with complete recanalization has not been analyzed. We hypothesized that IVT is associated with worse functional outcome and aggravated secondary injury volumes when administered to patients who subsequently attained complete reperfusion after EVT. Anterior circulation ischemic stroke patients with complete reperfusion after thrombectomy defined as thrombolysis in cerebral infarctions (TICI) scale 3 after thrombectomy admitted between January 2013-January 2021 were analyzed. Primary endpoints were the proportion of patients with functional independence defined as modified Rankin Scale (mRS) score 0-2 at day 90, and secondary injury volumes: Edema volume in follow-up imaging measured using quantitative net water uptake (NWU), and the rate of symptomatic intracerebral hemorrhage (sICH). A total of 219 patients were included and 128 (58%) patients received bridging IVT before thrombectomy. The proportion of patients with functional independence was 28% for patients with bridging IVT, and 34% for patients with direct thrombectomy (p = 0.35). The rate of sICH was significantly higher after bridging IVT (20% versus 7.7%, p = 0.01). Multivariable logistic and linear regression analysis confirmed the independent association of bridging IVT with sICH (aOR: 2.78, 95% CI: 1.02-7.56, p = 0.046), and edema volume (aOR: 8.70, 95% CI: 2.57-14.85, p = 0.006). Bridging IVT was associated with increased edema volume and risk for sICH as secondary injury volumes. The results of this study encourage direct EVT approaches, particularly in patients with higher likelihood of successful EVT.

AB - Intravenous thrombolytic therapy with alteplase (IVT) is a standard of care in ischemic stroke, while recent trials investigating direct endovascular thrombectomy (EVT) approaches showed conflicting results. Yet, the effect of IVT on secondary injury volumes in patients with complete recanalization has not been analyzed. We hypothesized that IVT is associated with worse functional outcome and aggravated secondary injury volumes when administered to patients who subsequently attained complete reperfusion after EVT. Anterior circulation ischemic stroke patients with complete reperfusion after thrombectomy defined as thrombolysis in cerebral infarctions (TICI) scale 3 after thrombectomy admitted between January 2013-January 2021 were analyzed. Primary endpoints were the proportion of patients with functional independence defined as modified Rankin Scale (mRS) score 0-2 at day 90, and secondary injury volumes: Edema volume in follow-up imaging measured using quantitative net water uptake (NWU), and the rate of symptomatic intracerebral hemorrhage (sICH). A total of 219 patients were included and 128 (58%) patients received bridging IVT before thrombectomy. The proportion of patients with functional independence was 28% for patients with bridging IVT, and 34% for patients with direct thrombectomy (p = 0.35). The rate of sICH was significantly higher after bridging IVT (20% versus 7.7%, p = 0.01). Multivariable logistic and linear regression analysis confirmed the independent association of bridging IVT with sICH (aOR: 2.78, 95% CI: 1.02-7.56, p = 0.046), and edema volume (aOR: 8.70, 95% CI: 2.57-14.85, p = 0.006). Bridging IVT was associated with increased edema volume and risk for sICH as secondary injury volumes. The results of this study encourage direct EVT approaches, particularly in patients with higher likelihood of successful EVT.

U2 - 10.3390/jcm11061565

DO - 10.3390/jcm11061565

M3 - SCORING: Journal article

C2 - 35329891

VL - 11

JO - J CLIN MED

JF - J CLIN MED

SN - 2077-0383

IS - 6

M1 - 1565

ER -