2008
DOI: 10.3174/ajnr.a1236
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Abstract: BACKGROUND AND PURPOSE Since the introduction of recombinant tissue plasminogen activator (rtPA) into clinical practice in the mid 1990s, no adjunctive treatment has further improved clinical outcomes in patients with ischemic stroke. The safety, feasibility, and efficacy of combining intravenous (IV) rtPA with endovascular interventions has been described; however, no direct comparative study has yet established whether endovascular interventions after IV rtPA are superior to IV rtPA alone. A retrospective ca… Show more

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Cited by 35 publications
(19 citation statements)
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“…[16][17][18] According to the actual IVT protocols, [19][20][21] rapid neurological improvement excludes patients from treatment, and substantial improvement after IVT prevents attempts of combined approach. 22,23 The reason is that early neurological improvement is a predictor of good outcome in stroke, [24][25][26][27][28][29] in 1 small study 28 independent from recanalization. The increasing availability of angioimaging techniques raises the question whether recanalization status or change of neurological symptoms is the most relevant information for a decision to proceed with an additional intervention.…”
Section: Strokementioning
confidence: 99%
“…[16][17][18] According to the actual IVT protocols, [19][20][21] rapid neurological improvement excludes patients from treatment, and substantial improvement after IVT prevents attempts of combined approach. 22,23 The reason is that early neurological improvement is a predictor of good outcome in stroke, [24][25][26][27][28][29] in 1 small study 28 independent from recanalization. The increasing availability of angioimaging techniques raises the question whether recanalization status or change of neurological symptoms is the most relevant information for a decision to proceed with an additional intervention.…”
Section: Strokementioning
confidence: 99%
“…The techniques for endovascular treatment have been described in detail in previous publications. [6][7][8][9][10] Briefly, a combination of pharmacologic agents and/or mechanical thrombus disruption and/or retrieval is used in varying paradigms.…”
Section: Technical Description For Endovascular Treatmentmentioning
confidence: 99%
“…Since neurointervention may not be recommended as the first-line treatment in patients who are eligible for intravenous tPA due to delays associated with endovascular interventions [37], combined intravenous tPA with subsequent intra-arterial tPA (bridging) and/or mechanical thrombectomy has been proposed to improve recanalization rates and ultimately outcome [38, 39]: The IMS trials [39] demonstrated comparable intracranial hemorrhage rates which were comparable to those in the NINDS trial and there was a trend towards lower mortality rates in the patients subjected to bridging therapy in the IMS study (16%) compared to both the placebo (24%) and tPA-treated (21%) groups in the NINDS study.…”
Section: Thrombolysis Beyond Intravenous Tpa In the 3-hour Time Windowmentioning
confidence: 99%