ESOC 2021 | Adjunctive intravenous thrombectomy in patients with acute LVO: a systematic review of RCTs

Georgios Tsivgoulis, MD, PhD, MSc, FESO, FEAN, FAAN, National and Kapodistrian University of Athens, Athens, Greece, shares the findings of a systematic review and meta-analysis of randomized controlled trials assessing the use of intravenous alteplase prior to endovascular thrombectomy for patients with acute large vessel occlusion. Three trials which compared direct mechanical thrombectomy (MT) to the combination of mechanical thrombectomy and intravenous thrombolysis (bridging therapy) were included in the analysis. It was demonstrated that patients treated with direct MT and bridging therapy showed no differences in functional outcomes, but those receiving direct MT did show a significantly lower likelihood of successful recanalization before the endovascular procedure compared to those who received bridging therapy. Bridging therapy was associated with a higher risk of intracranial bleeding as compared to direct MT, but was not associated with a significant increase in the risk of symptomatic intracranial hemorrhage. This interview took place at the European Stroke Organisation Conference (ESOC), 2021.