Core Concepts
Thrombolysis plus thrombectomy benefits are time-dependent.
Abstract
In a study presented at the International Stroke Conference 2024, researchers analyzed the benefits of thrombolysis plus thrombectomy compared to thrombectomy alone in patients presenting at thrombectomy-capable stroke centers. The study found that the benefit of thrombolysis plus thrombectomy was significant only if the time from symptom onset to expected thrombolysis administration was short, emphasizing the time sensitivity of this treatment approach.
Key Highlights:
- Time-dependent benefit of thrombolysis plus thrombectomy.
- Significant association with favorable functional outcomes within 2 hours 20 minutes.
- Decline in benefit with longer delays in thrombolysis administration.
- Importance of considering time in decision-making for thrombolysis administration.
Stats
"The benefit of thrombolysis plus thrombectomy decreased with longer times from symptom onset to expected administration of thrombolysis; adjusted common odds ratio for a 1-step modified Rankin Scale (mRS) score shift toward improvement was 1.49 at 1 hour, 1.25 at 2 hours, and 1.04 at 3 hours."
"For an mRS score of 0-2, the predicted absolute risk difference was 9% at 1 hour, 5% at 2 hours, and 1% at 3 hours."
Quotes
"Our results suggest a reasonably large benefit associated with thrombolysis plus thrombectomy if thrombolysis was administered early."
"There appeared to be equipoise among practicing clinicians on the issue of giving thrombolysis before thrombectomy."