Abstract
Objectives: To compare effectiveness and safety of mechanical thrombectomy applied in patients with acute ischemic stroke due to large vessel occlusions. Subjects and methods: A prospective control trial in 80 eligible patients with anterior circulation acute ischemic stroke due to large vessel occlusions who received standard-dose (0.9mg/kg) (control group) or non-standard-dose (0.6mg/kg) (intervention group) intravenous thrombolysis and then treated with mechanical thrombectomy; Compare effectiveness by reperfusion rate and 90-day-post-onset modified Rankin scale, compare safety of the methods through the incidence of intracranial hemorrhage complications and mortality. Results: There was no difference between the standard-dose group and the non-standard-dose group in good reperfusion rate (TICI 2b-3: 95% vs. 97.5%, p = 1.00) and good recovery rate at day 90 (modified Rankin scale: 72.5% vs. 82.5%, p = 0.284), the difference was statistically significant when the rates of asymptomatic and symptomatic intracranial hemorrhage were higher in the standard-dose group (12.5% and 27.5%) compared with the non-standard-dose group (0% and 22.5%) (p = 0.048); the mortality was statistically significantly higher in the standard-dose group compared to the non-standard-dose group at day 45 post-stroke (15% vs. 0%, p = 0.026) and tended to be significant at day 90 (17.5% vs. 2.5%, p = 0.057). Conclusion: In patients receiving bridging therapy for acute ischemic stroke, there were no diferrences in reperfusion rate and 90-day good outcome between standard and non-standard dose groups, symptomatic intracranial hemorrhage and mortality were relatively low but tended to be higher in the standard-dose group.
