Lecture from SLICE 2018
2 october 2018 – 8:55
by Pierre SENERS
Lysis or not: recanalisation by IV-tPA or MT
Are there certain patients who will profit from early recanalisation following IV-tPA? Pierre Seners begins with the observation that early recanalisation occurred after IV-thrombolysis in 20% of cases, perhaps meaning that transfer of these patients for mechanical thrombectomy (MT) might be unnecessary. He then presents the PREDICT-RECANAL study designed to determine the incidence of early recanalisation in patients referred for MT, deriving a clinical-radiological score for use in clinical practice to estimate the probability of early recanalisation following IV-tPA.
Discover the 3 key indicators in the 6-point predictor score – thrombus length, the occlusion site and the critical question of timing, seen in whether the patient is treated by the drip-and-ship method or the mothership. Based on this work, P. Seners goes on to discuss the results of the EXTEND-IA TNK trial and the use of tenecteplase vs. alteplase to see whether the same results would hold true in drip-and-ship patients. How did these observations differ from the EXTEND-IA TNK trial? Can using this scoring system change the paradigm of how we take charge of our stroke patients?
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