Outcomes of endovascular treatment alone or with intravenous alteplase in acute ischemic stroke Patients: A retrospective cohort study

Abstract

Objective: The aim of this study is to compare the clinical outcomes, safety, and workflow of patients who underwent endovascular treatment (EVT) alone or in combination with intravenous thrombolysis (IVT), against a control group who only received EVT. Methods: A retrospective analysis from May 2018 to September 2021 was conducted on 50 patients exhibiting acute ischemic stroke symptoms. 35 patients received EVT alone, while 15 received EVT and IVT. The data collected included demographic information, comorbid diseases, symptom onset time, duration from admission to puncture, and clinical outcomes via the National Institutes of Health Stroke Scale score and modified Rankin scale score at admission and 90 days post-procedure. Results: No significant differences were observed in the 90-day modified Rankin scale scores between the EVT + IVT and EVT alone groups (p > 0.05). NIHSS scores were also similar between the groups (p > 0.05). The EVT + IVT group demonstrated higher intracranial hemorrhage and symptomatic intracranial hemorrhage rates than the EVT alone group, but the difference became insignificant after adjusting for age and sex (p 0.05). Conclusion: The combined EVT and IVT treatment's safety outcomes are not inferior, aligning with existing literature.

Keywords

• Large vessel occlusion
• Acute ischemic stroke
• Mechanical thrombectomy
• Endovascular treatment
• EVT