Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different

Background and Purpose Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients. Methods Using region-wide registry data, we selected...

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Autores: Abilleira, S, Ribera, A, Cardona, P, Rubiera, M, López-Cancio, E, Amaro, S, Rodríguez-Campello, A, Camps-Renom, P, Cánovas, D, de Miquel, MA, Tomasello, A, Remollo, S, López-Rueda, A, Vivas, E, Perendreu, J, Gallofré, M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p5962
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/5962
Access Level:acceso abierto
Palabra clave:endovascular treatment
reperfusion
stroke
thrombectomy
thrombolysis
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spelling Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not DifferentAbilleira, SRibera, ACardona, PRubiera, MLópez-Cancio, EAmaro, SRodríguez-Campello, ACamps-Renom, PCánovas, Dde Miquel, MATomasello, ARemollo, SLópez-Rueda, AVivas, EPerendreu, JGallofré, Mendovascular treatmentreperfusionstrokethrombectomythrombolysisBackground and Purpose Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients. Methods Using region-wide registry data, we selected cases that received direct EVT or combined intravenous thrombolysis+EVT for anterior circulation strokes between January 2011 and October 2015. Treatment effect was estimated by stratification on a propensity score. The average odds ratios for the association of treatment with good outcome and death at 3 months and symptomatic bleedings at 24 hours were calculated with the Mantel-Haenszel test statistic. Results We included 599 direct EVT patients and 567 patients with combined treatment. Stratification through propensity score achieved balance of baseline characteristics across treatment groups. There was no association between treatment modality and good outcome (odds ratio, 0.97; 95% confidence interval, 0.74-1.27), death (odds ratio, 1.07; 95% confidence interval, 0.74-1.54), or symptomatic bleedings (odds ratio, 0.56; 95% confidence interval, 0.25-1.27). Conclusions This observational study suggests that outcomes after direct EVT or combined intravenous thrombolysis+EVT are not different. If confirmed by a randomized controlled trial, it may have a significant impact on organization of stroke systems of care.LIPPINCOTT WILLIAMS & WILKINS2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/5962STROKEISSN: 00392499ISSNe: 15244628reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p59622026-06-21T15:30:37Z
dc.title.none.fl_str_mv Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
title Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
spellingShingle Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
Abilleira, S
endovascular treatment
reperfusion
stroke
thrombectomy
thrombolysis
title_short Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
title_full Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
title_fullStr Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
title_full_unstemmed Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
title_sort Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
dc.creator.none.fl_str_mv Abilleira, S
Ribera, A
Cardona, P
Rubiera, M
López-Cancio, E
Amaro, S
Rodríguez-Campello, A
Camps-Renom, P
Cánovas, D
de Miquel, MA
Tomasello, A
Remollo, S
López-Rueda, A
Vivas, E
Perendreu, J
Gallofré, M
author Abilleira, S
author_facet Abilleira, S
Ribera, A
Cardona, P
Rubiera, M
López-Cancio, E
Amaro, S
Rodríguez-Campello, A
Camps-Renom, P
Cánovas, D
de Miquel, MA
Tomasello, A
Remollo, S
López-Rueda, A
Vivas, E
Perendreu, J
Gallofré, M
author_role author
author2 Ribera, A
Cardona, P
Rubiera, M
López-Cancio, E
Amaro, S
Rodríguez-Campello, A
Camps-Renom, P
Cánovas, D
de Miquel, MA
Tomasello, A
Remollo, S
López-Rueda, A
Vivas, E
Perendreu, J
Gallofré, M
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv endovascular treatment
reperfusion
stroke
thrombectomy
thrombolysis
topic endovascular treatment
reperfusion
stroke
thrombectomy
thrombolysis
description Background and Purpose Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients. Methods Using region-wide registry data, we selected cases that received direct EVT or combined intravenous thrombolysis+EVT for anterior circulation strokes between January 2011 and October 2015. Treatment effect was estimated by stratification on a propensity score. The average odds ratios for the association of treatment with good outcome and death at 3 months and symptomatic bleedings at 24 hours were calculated with the Mantel-Haenszel test statistic. Results We included 599 direct EVT patients and 567 patients with combined treatment. Stratification through propensity score achieved balance of baseline characteristics across treatment groups. There was no association between treatment modality and good outcome (odds ratio, 0.97; 95% confidence interval, 0.74-1.27), death (odds ratio, 1.07; 95% confidence interval, 0.74-1.54), or symptomatic bleedings (odds ratio, 0.56; 95% confidence interval, 0.25-1.27). Conclusions This observational study suggests that outcomes after direct EVT or combined intravenous thrombolysis+EVT are not different. If confirmed by a randomized controlled trial, it may have a significant impact on organization of stroke systems of care.
publishDate 2017
dc.date.none.fl_str_mv 2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/5962
url https://i3pt.portalinvestigacion.com/publicaciones/5962
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv LIPPINCOTT WILLIAMS & WILKINS
publisher.none.fl_str_mv LIPPINCOTT WILLIAMS & WILKINS
dc.source.none.fl_str_mv STROKE
ISSN: 00392499
ISSNe: 15244628
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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