Stroke; a journal of cerebral circulation
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Meta Analysis
Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients: A Meta-Analysis.
Whether prior intravenous thrombolysis provides any additional benefits to the patients undergoing mechanical thrombectomy for large vessel, acute ischemic stroke remains unclear. ⋯ Our results demonstrated that MT+IVT patients had better functional outcomes, lower mortality, higher rate of successful recanalization, requiring lower number of device passes, and equal odds of symptomatic intracerebral hemorrhage compared with MT-IVT patients. The results support the current guidelines of offering intravenous thrombolysis to eligible patients even if they are being considered for mechanical thrombectomy. Because the data are compiled from studies where the 2 groups differed based on eligibility for intravenous thrombolysis, randomized trials are necessary to accurately evaluate the added value of intravenous thrombolysis in patients treated with mechanical thrombectomy.
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The goal of this nationwide study is to evaluate the suitability of readmission as a quality indicator in the aneurysmal subarachnoid hemorrhage (SAH) population. ⋯ In this national analysis, readmission was primarily attributable to new medical complications in patients with greater comorbidities and severity of SAH rather than exacerbation of complications from the SAH hospitalization. Additionally, hospital readmission rates did not correlate with other established quality metrics. Therefore, readmission may be a suboptimal quality indicator in the SAH population.
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Early prediction of outcome in acute ischemic stroke is important for clinical management. This study aimed to compare the relationship between early follow-up multimodality computed tomographic (CT) imaging and clinical outcome at 90 days in a large multicenter stroke study. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT00880113.
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Ticagrelor is an effective antiplatelet therapy among patients with atherosclerotic disease and, therefore, could be more effective than aspirin in preventing recurrent stroke and cardiovascular events among patients with embolic stroke of unknown source (ESUS), which includes patients with ipsilateral stenosis <50% and aortic arch atherosclerosis. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT01994720.
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Differing associations of vascular risk factors with lacunar infarct have been reported, which is likely because of diagnostic differences and possible heterogeneity in the pathogenesis underlying lacunar infarction. In a large magnetic resonance imaging-verified cohort of lacunar infarct patients, we investigated the risk factor profile of lacunar infarction and magnetic resonance imaging characteristics. ⋯ In this magnetic resonance imaging-verified lacunar stroke population, we identified a distinct risk factor profile in the group as a whole. However, there were differing risk factor profiles according to the presence of multiple lacunar infarcts and confluent WMH. The association of hypertension, smoking, and renal impairment with the presence of multiple lacunar infarcts and confluent WMH might reflect a diffuse small vessel arteriopathy.