Thrombolysis Versus Thrombolysis Plus Thrombectomy in Stroke

A retrospective analysis published in the Journal of Neurology conducted a comparison between mechanical thrombectomy alone versus intravenous thrombolysis and mechanical thrombectomy in acute ischemic stroke.¹

A total of 325 patients were analyzed. No difference was found in safety and efficacy outcomes. After multivariate analysis, the combined treatment was not associated with lower mortality.

So, according to this study, mechanical thrombectomy alone is safe and effective in patients with contraindications to intravenous thrombolysis. These findings support an earlier study published in JAMA Neurology.²

The study was a pooled analysis of SWIFT and STAR studies, concluding that the addition of intravenous thrombolysis did not appear to add clinical benefit in acute ischemic stroke. Further studies are needed.

References:

1. Sallustio F, Koch G, Alemseged F, et al. Effect of mechanical thrombectomy alone or in combination with intravenous thrombolysis for acute ischemic stroke. 

J Neurol.

 2018;265:2875-2880.

2. Coutinho JM, Liebeskind DS, Slater LA, et al. Combined Intravenous Thrombolysis and Thrombectomy vs Thrombectomy Alone for Acute Ischemic Stroke: A Pooled Analysis of the SWIFT and STAR Studies. JAMA Neurol. 2017;74:268-274.