Outcome after intravenous thrombolysis in embolic stroke of undetermined source compared to cardioembolic stroke

Živanović, Željko; Ostojic, Zorana; Rajić, Sonja; Vlahović, Dmitar; Mijajlović, Milija; Jovićević, M

doi:10.1007/s00508-020-01727-5

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…Furthermore, the study indicated that combined therapy was better than EVT-alone in achieving successful reperfusion in patients with UC than in those with CE, although the difference did not change the clinical outcomes. The result was similar to a previous finding that patients with embolic stroke of an undetermined source had better outcome than those with cardioembolic stroke 24. Previous studies indicated that part of undetermined-source stroke was of cardiac origin, including paroxysmal atrial fibrillation and patent foramen ovale checked using repeated Holter electrocardiography or an implantable device, or cardiac MRI of the left ventricle 25 26.…”

Section: Discussionsupporting

confidence: 89%

Effect of stroke etiology on endovascular thrombectomy with or without intravenous alteplase: a subgroup analysis of DIRECT-MT

Xing

Zhang

Shen

et al. 2022

J NeuroIntervent Surg

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BackgroundStroke etiology might influence the clinical outcomes in patients with large vessel occlusion receiving endovascular treatment (EVT) with or without thrombolysis.ObjectiveTo examine whether stroke etiology resulted in different efficacy and safety in patients treated with EVT-alone or EVT preceded by intravenous alteplase (combined therapy).MethodsWe assessed the efficacy and safety of treatment strategy based on prespecified stroke etiology, cardioembolism (CE), large-artery atherosclerosis (LAA), and undetermined cause (UC) for patients enrolled in the DIRECT-MT trial. The primary outcome was the modified Rankin Scale (mRS) score at 90 days. Multivariate ordinal logistic regression analysis was used to calculate the adjusted common OR for a shift of better mRS score for EVT-alone versus combined therapy. A term was entered to test for interaction.ResultsIn this study, 656 patients were grouped into three prespecified stroke etiologic subgroups. The adjusted common ORs for improvement in the 90-day ordinal mRS score with EVT-alone were 1.2 (95% CI 0.8 to 1.8) for CE, 1.6 (95% CI 0.8 to 3.3) for LAA, and 0.8 (95% CI 0.5 to 1.3) for UC. Compared with CE, EVT-alone was more likely to result in an mRS score of 0–1 (pinteraction=0.047) and extended Thrombolysis in Cerebral Infarction ≥2b (pinteraction=0.041) in the LAA group. The differences in mortality and symptomatic intracranial hemorrhage within 90 days were not significant between the subgroups (p＞0.05).ConclusionsThe results did not support the hypothesis that a specific treatment strategy based on stroke etiology should be used for patients with large vessel occlusion (NCT03469206).

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Section: Discussionsupporting

confidence: 89%

Effect of stroke etiology on endovascular thrombectomy with or without intravenous alteplase: a subgroup analysis of DIRECT-MT

Xing

Zhang

Shen

et al. 2022

J NeuroIntervent Surg

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“…The researchers concluded that the presence and severity of SVD burden were predictive of poor clinical outcomes and significantly linked to symptomatic HT after IVT. Apart from that, the absence of LA, among other variables, was shown to be an independent predictor of favorable outcomes at 3 months poststroke in 394 patients treated with IVT in a study conducted by Zivanovic et al [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Elucidating the Role of Baseline Leukoaraiosis on Forecasting Clinical Outcome of Acute Ischemic Stroke Patients Undergoing Reperfusion Therapy

Karatzetzou

Tsiptsios

Sousanidou

et al. 2022

Neurology International

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Stroke stands as a major cause of death and disability with increasing prevalence. The absence of clinical improvement after either intravenous thrombolysis (IVT) or mechanical thrombectomy (MT) represents a frequent concern in the setting of acute ischemic stroke (AIS). In an attempt to optimize overall stroke management, it is clinically valuable to provide important insight into functional outcomes after reperfusion therapy among patients presenting with AIS. The aim of the present review is to explore the predictive value of leukoaraiosis (LA) in terms of clinical response to revascularization poststroke. A literature research of two databases (MEDLINE and Scopus) was conducted in order to trace all relevant studies published between 1 January 2012 and 1 November 2022 that focused on the potential utility of LA severity regarding reperfusion status and clinical outcome after revascularization. A total of 37 articles have been traced and included in this review. LA burden assessment is indicative of functional outcome post-intervention and may be associated with hemorrhagic events’ incidence among stroke individuals. Nevertheless, LA may not solely guide decision-making about treatment strategy poststroke. Overall, the evaluation of LA upon admission seems to have interesting prognostic potential and may substantially enhance individualized stroke care.

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Combining machine learning with radiomics features in predicting outcomes after mechanical thrombectomy in patients with acute ischemic stroke

Liu²,

Zhao³

et al. 2022

Computer Methods and Programs in Biomedicine

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Outcome after intravenous thrombolysis in embolic stroke of undetermined source compared to cardioembolic stroke

Cited by 4 publications

References 20 publications

Effect of stroke etiology on endovascular thrombectomy with or without intravenous alteplase: a subgroup analysis of DIRECT-MT

Effect of stroke etiology on endovascular thrombectomy with or without intravenous alteplase: a subgroup analysis of DIRECT-MT

Elucidating the Role of Baseline Leukoaraiosis on Forecasting Clinical Outcome of Acute Ischemic Stroke Patients Undergoing Reperfusion Therapy

Combining machine learning with radiomics features in predicting outcomes after mechanical thrombectomy in patients with acute ischemic stroke

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