Format

Send to

Choose Destination
Curr Neurovasc Res. 2018;15(3):204-210. doi: 10.2174/1567202615666180717113526.

Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patients Receiving Thrombectomy: Standard or Low Dose Therapy?

Lin CH1, Liu CH2,3,4, Wang AY3,5, Wu YM3,6, Chen CC3,5, Tsai YH3,7, Chang TY2,3, Huang KL2,3, Wu HC2,3, Lee TH2,3, Chang YJ2,3,8, Lin CM2, Cheng CK2, Chang CH2,3,9.

Author information

1
Department of Neurology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
2
Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
3
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
4
Division of Medical Education, Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
5
Department of Neurosurgery, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
6
Department of Medical Imaging and Intervention, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
7
Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
8
Chang Gung Medical Education Research Centre, Taoyuan, Taiwan.
9
Department of Electrical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan.

Abstract

BACKGROUND:

We compared the clinical outcomes of low and standard dose recombinant tissue Plasminogen Activator (rtPA) treatment in Acute Ischemic Stroke (AIS) patients receiving Endovascular Mechanical Thrombectomy (EVT).

METHODS:

Between April 01, 2015 and September 30, 2017, all AIS patients admitted to the Linkou and Chiayi Chang Gung Memorial Hospital were retrospectively reviewed. Patients with large vessel occlusions, who underwent bridging therapy with rtPA and EVT, were further enrolled. The enrolled patients were categorized into low (0.6-0.7 mg/kg; LD) or standard dose (0.9 mg/kg; SD) group based on the dose of rtPA they received. Baseline characteristics, reperfusion status, and clinical outcomes were compared between the two groups.

RESULTS:

Forty-two patients were enrolled in the final analyses, including 13 in the LD and 29 in the SD group. In all groups analyzed, the frequencies of moderate to severe and severe stroke at discharge were significantly decreased compared to those at stroke onset (p < 0.01). Compared to the SD group, patients of the LD group had a similar rate of mortality (LD vs. SD; 0% vs. 3.4%, p = 1.00), and comparable frequencies of functional independence at 3 months after stroke onset (LD vs. SD; 33.3% vs. 44.8%, p = 0.50). The rates of symptomatic intracerebral hemorrhage were also similar between the two groups (LD vs. SD; 0% vs. 6.9%, p =1.00).

CONCLUSIONS:

Compared to standard dose treatment, low dose rtPA may have similar clinical efficacy and safety outcomes in AIS patients receiving bridging therapy.

KEYWORDS:

Acute ischemic stroke; acute stroke therapy; dose; large vessel occlusions; mechanical thrombectomy; tissue plasminogen activator.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Bentham Science Publishers Ltd.
Loading ...
Support Center