Better outcomes associated with IV thrombolysis followed by mechanical thrombectomy versus mechanical thrombectomy alone
FRIDAY, Feb. 18, 2022 (HealthDay News) — For patients with anterior circulation large vessel occlusion (LVO) stroke, use of intravenous thrombolysis followed by mechanical thrombectomy (MT; also known as bridging therapy [BT]) is associated with increased odds of functional independence and successful reperfusion and reduced odds of mortality compared with MT alone, according to a review published online Feb. 16 in Neurology.
Gabriela Trifan, M.D., from the University of Illinois at Chicago College of Medicine, and colleagues compared the efficacy and safety of BT to that of MT for anterior circulation LVO in a systematic review and meta-analysis of data from 41 studies with 14,885 patients.
The researchers found that the odds of functional independence and successful reperfusion were increased for patients receiving BT versus those receiving MT (odds ratios, 1.29 and 1.25, respectively), and there was a decrease in the odds of mortality (odds ratio, 0.69). The prevalence of symptomatic hemorrhage (sICH) did not differ significantly between the groups. Six of the studies were randomized clinical trials with intention-to-treat analysis involving patients presenting directly to MT-capable centers; no between-group differences were seen in functional independence, sICH, or mortality when the analysis was restricted to these trials. However, the odds of successful reperfusion were increased in the BT group (odds ratio, 1.35).
“We found that bridging therapy was also linked to better chances for more robust blood flow returning to the brain after stroke, and in turn, better functional independence for people after stroke,” Trifan said in a statement.
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