title: Evaluation of the recombinant tissue plasminogen activator pretreatment in acute stroke patients with large vessel occlusions treated with the direct bridging approach. Is it worth the effort?
abstract: OBJECTIVE
  The direct bridging concept in acute stroke treatment combines intravenous thrombolysis (IVT) and endovascular treatment (EVT). The frequency and extent of reperfusion obtained already due to IVT were evaluated. Additionally undesired events and the clinical outcome were analysed.
  
  
  METHODS
  Fifty-seven acute stroke patients treated with direct bridging were analysed for this study. The response to IVT was evaluated according to the modified Thrombolysis in Cerebral Infarction scale (m-TICI). IVT responders (m-TICI ≥2B in digital subtraction angiography) were compared with IVT non-responders (m-TICI <2B in digital subtraction angiography) with respect to clinical outcome and occurrence of undesired events.
  
  
  RESULTS
  Fourteen patients (25%) got a change from TICI 0 to ≥2B due to IVT alone. There were otherwise no differences between the IVT responders and IVT non-responders.
  
  
  CONCLUSIONS
  Intravenous thrombolysis pretreatment in the context of the bridging approach contributes substantially to revascularization.
authors.affiliation: Department of Radiology, Stavanger University Hospital, Stavanger, Norway; Neuroscience Research Group, Stavanger University Hospital, Stavanger, Norway.
authors.forename: L
authors.initials: L
authors.lastname: Fjetland
authors.forename: K D
authors.initials: KD
authors.lastname: Kurz
authors.forename: S
authors.initials: S
authors.lastname: Roy
authors.forename: M W
authors.initials: MW
authors.lastname: Kurz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003131:Combined Modality Therapy; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: acute ischaemic stroke; endovascular treatment; intravenous thrombolysis