CONy 2023 | Primary thrombectomy vs bridging thrombolysis in ischemic stroke

Anita Arsovska, MD, PhD, University of Ss Cyril and Methodius, Medical Faculty, Skopje, Macedonia, discusses whether intravenous thrombolysis (IVT) should always be offered to patients eligible for mechanical thrombectomy (MT). Although current guidelines recommend that patients suitable for IVT should receive it without delay, even if MT is being considered, the particular benefit of IVT in patients with large vessel occlusion (LVO) is a matter of debate. In 2015, 5 randomized controlled trials established that MT in combination with IVT (combined MT+IVT) was superior to IVT alone in patients with LVO in the anterior circulation. More recently, other trials have shown that mechanical thrombectomy alone, compared with combined intravenous thrombolysis plus mechanical thrombectomy, failed to demonstrate non-inferiority regarding favorable functional outcomes. This interview took place at the 17th World Congress on Controversies in Neurology (CONy) in Dubrovnik, Croatia.

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