In a study from the University of Bristol and elsewhere, scientists found giving blood thinning drug (thrombolysis) before treatment to remove a clot from the brain—known as thrombectomy procedure—to stroke patients, improved mortality rates at 90 days, compared with just thrombectomy procedure alone.
Mechanical thrombectomy is an effective treatment for patients with an acute stroke caused by a clot (ischemic stroke) from basilar artery occlusion, which occurs when the basilar artery, the main artery at the back portion of the brain, is blocked.
Administering a bridging blood thinning drug before removing a clot is still recommended for most patients with large-vessel occlusion pending results of randomized controlled trials.
However, in patients with basilar artery occlusion who undergo mechanical thrombectomy, it is not clear whether or not prior treatment with a bridging blood-thinning drug is beneficial.
In the study, the team looked at 51 prior studies and three studies were eligible to be included.
The three studies compared bridging intravenous thrombolysis with direct mechanical thrombectomy in 1,096 patients with stroke due to basilar artery occlusion.
Of the total 1,096 patients, 749 were male (68.3%) and 347 were female (31.7%).
362 patients underwent mechanical thrombectomy with bridging intravenous thrombolysis, while 734 patients underwent direct mechanical thrombectomy.
The team found that in patients with acute ischemic stroke due to basilar artery occlusion, compared with direct mechanical thrombectomy, bridging intravenous thrombolysis is associated with lower mortality rates at 90 days without an increased risk of bleeding.
Bridging intravenous thrombolysis is also linked to better functional outcomes, particularly in patients with large atherosclerosis, which is the build-up of fatty material inside arteries.
It’s a potentially serious condition that causes most heart attacks and strokes but often goes unnoticed.
The research team suggests future randomized controlled trials are needed to validate whether bridging intravenous thrombolysis does provide benefits over direct mechanical thrombectomy in stroke patients with basilar artery occlusion.
If you care about stroke, please read studies about a major cause of stroke, and drinking coffee this way may prevent heart disease and stroke.
The study was conducted by Keng Siang Lee et al and published in the Journal of NeuroInterventional Surgery.
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