METHODS: From January 2013 through July 2019, consecutive patients with acute ischemic cerebrovascular disease due to LAA who were admitted within 6 hours from symptom onset were recruited. The patients were classified into six groups based on the reperfusion treatment and early (within 24 hours) AT from rt-PA treatment. Safety outcomes were compared among the groups.
RESULTS: A total of 155 patients (35 women [23%], median age 74 [IQR 66-79] years; NIHSS score 3 [1-10]) were included in the present study. Of these, 73 (47%) received no reperfusion therapy, 24 (15%) received rt-PA treatment and early AT, seven (6%) received rt-PA without early AT, 26 (17%) received EVT only, six (4%) received both rt-PA and EVT without early AT, and 19 (12%) received rt-PA and EVT with early AT. AT was administered a median of 3.9 (1.6-8.0) hours after rt-PA in patients with rt-PA+EVT with early AT. AT within 24 hours after rt-PA and EVT treatment did not increase hemorrhagic complications (p > 0.05 for all).
CONCLUSIONS: In this retrospective analyses, early AT administration for patients with hyperacute stroke due to LAA treated with rt-PA plus EVT did not increase hemorrhagic events.
方法:从2013年1月至2019年7月,招募症状发作后6小时内收治的LAA所致急性缺血性脑血管病患者。根据再灌注治疗和rt-PA治疗的早期(24小时内)AT将患者分为6组。比较各组的安全性结果。
结果:共155名患者(35名女性[23%],中位年龄74[IQR66-79]岁;NIHSS评分3[1-10])纳入本研究。其中,73人(47%)未接受再灌注治疗,24(15%)接受rt-PA治疗和早期AT,七个(6%)在没有提前AT的情况下接受了rt-PA,26(17%)只接受EVT,6人(4%)同时接受rt-PA和EVT,没有早期AT,19人(12%)接受rt-PA和EVT治疗,早期AT。在rt-PA+EVT合并早期AT的患者中,在rt-PA后中位3.9(1.6-8.0)小时给予AT。在rt-PA和EVT治疗后24小时内AT没有增加出血性并发症(均p>0.05)。
结论:在本回顾性分析中,对于接受rt-PA加EVT治疗的LAA导致的超急性卒中患者,早期AT治疗不会增加出血性事件.