Treating acute large vessel occlusion stroke: to bridge or not to bridge?

Stroke and Vascular Neurology

article

Yunyun Xiong¹  Yuesong Pan²  Raul G Nogueira³  Zeguang Ren⁴  Tudor G Jovin⁵  Yongjun Wang² 

[1] Neurology , Beijing Tiantan Hospital, Capital Medical University;China National Clinical Research Center for Neurological Diseases , Beijing Tiantan Hospital, Capital Medical University;Neurology, Marcus Stroke and Neuroscience Center, Grady Memorial Hospital , Emory University School of Medicine;Neurosurgery , Cleveland Clinic Martin Health;Cooper Neurologic Institute , Cooper University Hospital;Neurology , Cooper Medical School of Rowan University

关键词: stroke;    thrombectomy;    thrombolysis;   

DOI  :  10.1136/svn-2021-000952

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Hot debates exist regarding whether patientswho had an acute large vessel occlusion stroke(LVOS) can skip tissue plasminogen activator(tPA) and go directly to thrombectomy incomprehensive stroke centres. Three headto-head randomised clinical trials (RCTs)of direct endovascular treatment (dEVT)versus bridge therapy (BT) with intravenousalteplase have been recently completed in theAsian population. The DIRECT-MT (DirectIntraarterial Thrombectomy in Order toRevascularize Acute Ischemic Stroke Patientswith Large Vessel Occlusion Efficiently inChinese Tertiary Hospitals: a MulticenterRandomized Clinical Trial) Study randomlyenrolled 656 patients who had an acute ischaemic stroke with anterior circulation LVOSacross 41 large teaching hospitals in Chinato receive BT or dEVT within 4.5 hours aftersymptom onset.1 The study showed that thedEVT group was non-inferior to BT in termsof 90-day clinical outcomes (median 90-daymodified Rankin Scale (mRS), 3 vs 3; OR1.07; 95%CI 0.81 to 1.40; p=0.04).

【 授权许可】

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