Abstract T P12: Pretreatment With IV tPA Does Not Impact Outcome in Patients Undergoing Endovascular Stroke Treatment

Abstract

Objective: We sought to compare the clinical outcomes of patients who underwent Intra-arterial Treatment (IAT) IAT with or without IV tPA pretreatment at our center. METHODS: We reviewed records of AIS patients who underwent IAT at our center from July 2012 - Jul 2013. The following data were collected and analyzed: patients’ demographics, baseline characteristics, treatment times and methods, rate of symptomatic and asymptomatic intracerebral hemorrhage, and favorable clinical outcome defined as modified Rankin score (mRS) ≤ 2 at 90 days or at last observation for patients treated within the last 89 days RESULTS: Seventy consecutive patients who underwent IAT were identified. Overall 33 (47.1%) patients had favorable outcome. There were 15/70 (21.4%) asymptomatic and 2/70 (2.8%) symptomatic hemorrhages following IAT. Pretreatment with IV tPA 32/70 (45.7%) had no significant impact on the rate of asymptomatic (6/32, 18.7% versus 9/38, 23.6%) or symptomatic (1/32, 0.03% versus 1/38, 0.03%) ICH, p=0.8. There were no instances of retroperitoneal or groin hemorrhagic complications in either group. Rate of recanalization was comparable between the IV tPA (26/32, 81.2%) and non-IV tPA groups (32/38, 84.2%).Also the rate of favorable outcome was comparable between the IV tPA pretreatment (15/32, 46.8%) and non-IV tPA (18/38, 47.3%) groups. In a multivariate analysis, young age was the only predictor of favorable clinical outcome in this cohort (OR: 0.93; 95%CI: 0.88-0.99; p=0.03). CONCLUSION: Our results suggest that IV tPA pretreatment has no impact on eventual patient outcome following endovascular stroke treatment. This finding may be helpful in designing future randomized trials.