Abstract TMP5: Intravenous Thrombolysis Influence After Successful Mechanical Thrombectomy For Large Vessel Occlusion; Not To Skip Tpa Yet!

• DOI: 10.1161/str.54.suppl_1.tmp5
• Publication Date: 2023-02-02T10:16:12Z
• Authors: Ghada A Mohamed; Valerie L Sharf; Kevin Jacks; Robert Fugatt; William Lee; Evangelos Pavlos ...; Hamid Ali; Christine A Holms...
• Keywords: Stroke; Single Center; Fibrinolytic agent

Background: Despite the high rates of successful reperfusion in randomized mechanical thrombectomy (MT) trials, only 27% large vessel occlusion (LVO) patients treated successfully with MT achieved functional independence at 90 days. One proposed theory is impaired distal persistent small thrombi within microcirculation despite complete recanalization “the no-Reflow phenomenon”. These would be more suitable to dissolve by thrombolytics. Methods: This a retrospective cohort obtained from Get guidelines stroke (GWGS) database available Medical University South Carolina Comprehensive Stroke Center (CSC) for LVO presented 4.5 hours last known well (LNW) between January/2018- June/2022. We aim investigate influence intravenous thrombolysis (IVTPA) on mRS (0-2) after defined as modified score (mTICI2c-3). Results: Of 188 who (TICI2c-3) during study period, 93 (49%) arrived our CSC LSW, them 40 (43%) received IVTPA. There was no difference age, gender, race and initial NIHSS IVTPA those did not receive Patients earlier [median LNW 60 min IQR (51 - 151) vs 165 (IQR 103- 214), p = <0.001), had higher ASPECTS 9, (8-10) 7, (7-10) p= 0.027]. collaterals score, clot burden site LVO, tandem nature, door times, post-procedural intracranial hemorrhage or etiology two groups. Discharge group 65% 42% 0.025. After adjusting odds achieving discharge compared [aOR 2.42, 95%CI (1.02- 5.75), 0.046]. Conclusion: Intravenous can still patients' outcomes revascularization. positive effect might related microthrombi subsequent improvement flow beyond