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Tytuł:
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Prior IV Thrombolysis Facilitates Mechanical Thrombectomy in Acute Ischemic Stroke.
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Autorzy:
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Guedin P; Department of Diagnostic and Interventional Neuroradiology, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France; Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Larcher A; Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Decroix JP; Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Labreuche J; Department of Biostatistics, Lille University Medical Center, Lille, France.
Dreyfus JF; Department of Clinical Research and Innovation and Laboratory of Pharmacology, UPRES EA220, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Evrard S; Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Wang A; Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Graveleau P; Department of Diagnostic and Interventional Neuroradiology, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France; Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Tassan P; Division of Neurology, Stroke Center, Poissy Saint-Germain-En-Laye Hospital, Poissy, France.
Pico F; Department of Neurology and Stroke Center, Mignot Hospital, University Versailles Saint-Quentin en Yvelines, Le Chesnay, France.
Coskun O; Department of Diagnostic and Interventional Neuroradiology, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Rodesch G; Department of Diagnostic and Interventional Neuroradiology, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Bourdain F; Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France.
Lapergue B; Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Paris, France. Electronic address: .
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Źródło:
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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2015 May; Vol. 24 (5), pp. 952-7. Date of Electronic Publication: 2015 Mar 21.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
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MeSH Terms:
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Fibrinolytic Agents/*administration & dosage
Stroke/*therapy
Thrombectomy/*methods
Tissue Plasminogen Activator/*administration & dosage
Aged ; Female ; Humans ; Infusions, Intravenous/methods ; Ischemia/complications ; Male ; Middle Aged ; Retrospective Studies ; Statistics, Nonparametric ; Stroke/etiology ; Treatment Outcome
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Contributed Indexing:
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Keywords: Mechanical endovascular therapy; acute ischemic stroke - recanalization; intravenous thrombolysis by rtPA
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Substance Nomenclature:
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0 (Fibrinolytic Agents)
EC 3.4.21.68 (Tissue Plasminogen Activator)
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Entry Date(s):
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Date Created: 20150326 Date Completed: 20160111 Latest Revision: 20220318
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Update Code:
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20240104
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DOI:
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10.1016/j.jstrokecerebrovasdis.2014.12.015
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PMID:
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25804567
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Background: In acute ischemic stroke (AIS), bridging therapy, including intravenous thrombolysis (IVT) and mechanical thrombectomy (MET), appears to be very promising. However, data on the impact of IVT before the endovascular procedure are limited.
Methods: To examine the impact of IVT on the MET procedure, we compared the duration of this procedure, number of passes, recanalization rate, safety issues, and outcome in consecutively recruited patients either eligible for MET alone (intravenous fibrinolysis contraindication) or receiving MET preceded by IVT for proximal middle cerebral artery (MCA) occlusion within 6 hours of stroke onset.
Results: From January 2011 to June 2013, 68 cases with proximal MCA occlusion were available for analysis (MET alone, 40; IVT + MET, 28). The 2 groups did not differ significantly in baseline characteristics. The median National Institutes of Health Stroke Scale score at admission was 15 (10-20) for MET and 18 (13-19) for IVT + MET groups, respectively (P = .39). The median duration of the endovascular procedure (from groin puncture to recanalization) was significantly shorter in the IVT + MET group compared with that in MET alone (35 minutes [21-60] versus 60 minutes [25-91]; P = .043). The number of passes of the thrombectomy device per patient tended to be lower in the IVT + MET group than those in the MET group (P = .080). The IVT + MET group also had a higher rate of complete recanalization and a better outcome at 3 months.
Conclusions: Prior IVT may facilitate the MET procedure. Further studies on MET in AIS should assess the direct impact of IVT on the endovascular procedure.
(Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.)
