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Does Intravenous Thrombolysis Within 4.5 to 9 Hours Increase Clot Migration Leading to Endovascular Inaccessibility?
- Source :
-
Stroke [Stroke] 2021 Mar; Vol. 52 (3), pp. 1083-1086. Date of Electronic Publication: 2021 Feb 16. - Publication Year :
- 2021
-
Abstract
- Background and Purpose: Distal clot migration is a recognized event following intravenous thrombolysis (IVT) in the setting of acute ischemic stroke. Of note, clots that were initially retrievable by endovascular thrombectomy may migrate to a distal nonretrievable location and compromise clinical outcome. We investigated the incidence of clot migration leading to clot inaccessibility following IVT in the time window of 4.5 to 9 hours.<br />Methods: We performed a retrospective analysis of the EXTEND trial (Extending the Time for Thrombolysis in Emergency Neurological Deficits) data. Baseline and 12- to 24-hour follow-up clot location was determined on computed tomography angiogram or magnetic resonance angiogram. The incidence of clot migration leading to a change from retrievable to nonretrievable location was identified and compared between the two treatment groups (IVT versus placebo).<br />Results: Two hundred twenty patients were assessed. Clot migration from a retrievable to nonretrievable location occurred in 37 patients: 21 patients (19.3%) in the placebo group and 16 patients (14.4%) in the IVT group. No significant difference was identified in the incidence of clot migration leading to inaccessibility between groups ( P =0.336).<br />Conclusions: Our results did not show increased clot migration leading to clot inaccessibility in patients treated with IVT.
- Subjects :
- Administration, Intravenous
Aged
Computed Tomography Angiography
Fibrinolytic Agents administration & dosage
Fibrinolytic Agents therapeutic use
Follow-Up Studies
Humans
Incidence
Magnetic Resonance Angiography
Male
Middle Aged
Retrospective Studies
Time-to-Treatment
Treatment Outcome
Endovascular Procedures methods
Fibrinolytic Agents adverse effects
Ischemic Stroke therapy
Thrombolytic Therapy adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4628
- Volume :
- 52
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Stroke
- Publication Type :
- Academic Journal
- Accession number :
- 33588590
- Full Text :
- https://doi.org/10.1161/STROKEAHA.120.030661