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Original Article
- Neurology
- Effectiveness of intravenous thrombolysis in patients with large-vessel occlusion receiving endovascular treatment in South Korea
- Min Kim, Ji Sung Lee, Seong-Joon Lee, So Young Park, Jungyun Seo, Ji Man Hong, Hee-Kwon Park, Jae-Kwan Cha, Jeffrey L. Saver, Jin Soo Lee
- Acute Crit Care. 2025;40(2):282-292. Published online April 11, 2025
- DOI: https://doi.org/10.4266/acc.004248
- 4,731 View
- 93 Download
- 2 Web of Science
- 2 Crossref
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Abstract
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Supplementary Material - Background
The effectiveness of intravenous tissue plasminogen activator (IV tPA) in patients with large-vessel occlusion (LVO) receiving endovascular treatment (EVT) for acute ischemic stroke (AIS) has been questioned. We investigated IV tPA effectiveness in real-world AIS patients, including those with intracranial LVO receiving EVT.
Methods
We identified patients with AIS who presented to hospital with National Institutes of Health Stroke Scale ≥4 within 8 hours of symptom onset from the institutional stroke registry. The association of IV tPA use with effectiveness and safety outcomes was analyzed in overall enrolled AIS patients; LVO patients; and patients treated with EVT. The effect of IV tPA was assessed using multiple logistic regression.
Results
Among the 654 patients meeting study entry criteria, 238 (36.4%) received IV tPA and 416 (63.6%) did not. Multiple logistic regression analysis and shift analysis revealed IV tPA was associated with improved outcomes in overall enrolled AIS population, LVO, and EVT-treated subgroups. Among EVT-treated patients, IV tPA was associated with higher likelihood of ambulatory or better outcome (modified Rankin Scale 0–3) with odds ratio of 1.95 (P=0.03).
Conclusions
In this real-world study, IV tPA use was associated with improved outcomes for patients with AIS, including among LVO patients treated and not treated with EVT, in the contemporary mechanical thrombectomy era. -
Citations
Citations to this article as recorded by
- SMART-M24: A Prognostic Nomogram for Long-Term Mortality in Acute Ischemic Stroke Beyond 24 H from Symptom Onset
Soo-Hyun Park, Ji Sung Lee, Tae Jung Kim, Mi Sun Oh, Ji-Woo Kim, Kyungbok Lee, Kyung-Ho Yu, Byung-Chul Lee, Byung-Woo Yoon, Sang-Bae Ko
Translational Stroke Research.2025; 16(6): 1975. CrossRef - Knowledge and experience of local emergency care staff on stroke recognition and acute care in the United Arab Emirates
Mohammed Alkuwaiti, Azhar Talal, Emad Masuadi, Ghada Albluwi, Abdulla Alkuwaiti, David Olukolade Alao
International Journal of Emergency Medicine.2025;[Epub] CrossRef
- SMART-M24: A Prognostic Nomogram for Long-Term Mortality in Acute Ischemic Stroke Beyond 24 H from Symptom Onset
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