Abstract T P15: Could Intra-Arterial Thrombolysis Safely Enhance Efficacy of Mechanical Thrombectomy for Acute Ischemic Stroke?
Background: Occlusion of large intracranial arteries is associated with disability and death. In this study we assess whether intra-arterial thrombolysis(IAT) safely enhances efficacy of mechanical thrombectomy.
Method: We studied consecutive patients with acute large vessel occlusion. We compared 2 groups:(1) thrombectomy plus IAT and(2) thrombectomy alone (non-IAT). Recanalization was defined by TIMI ≥ 2.
Results: Between 12/2007 and 10/2012, 87 patients(age 67±16years) received 88 thrombectomy procedures. The median admission NIHSS was18. Forty six cases were treated IAT. Overall recanalization was 60%. Recanalization was seen more frequently in cases using IAT (72%) compared to non-IAT(48%)(p=0.02). IAT tended to associate with fewer numbers of arterial attempts than non-IAT (2.37±1.76 vs. 3.07± 1.98) (p=0.08) but longer procedure duration(119± 53 minutes vs. 90± 55 minutes)(p=0.02). The rate of symptomatic hemorrhagic transformation, in-hospital and 3 month mortality rates were not significantly different between IAT and non-IAT(p=0.90, p=0.99 and p=0.72), respectively.
Conclusions: During mechanical thrombectomy, IAT is associated with increased recanalization rate and longer procedure duration. Mechanical thrombectomy with concomitant IAT appeared relatively safe.
Author Disclosures: Y. Zhang: None. A. Kelly: None. W. Tang: None. R. Griggs: None. H. Wang: None. B. Jahromi: None. K. Young: None. C. Benesch: None.
- © 2014 by American Heart Association, Inc.