Intravenous Thrombolysis in Posterior versus Anterior
Circulation Stroke: Clinical Outcome Differs Only in Patients
with Large Vessel Occlusion

J 2024

Intravenous Thrombolysis in Posterior versus Anterior Circulation Stroke: Clinical Outcome Differs Only in Patients with Large Vessel Occlusion

HALUSKOVA, Simona, Roman HERZIG, Robert MIKULÍK, Silvie BELASKOVA, Martin REISER et. al.

Basic information

Original name

Intravenous Thrombolysis in Posterior versus Anterior Circulation Stroke: Clinical Outcome Differs Only in Patients with Large Vessel Occlusion

Authors

HALUSKOVA, Simona, Roman HERZIG, Robert MIKULÍK (203 Czech Republic, guarantor, belonging to the institution), Silvie BELASKOVA, Martin REISER, Lubomir JURAK, Daniel VACLAVIK, Michal BAR, Lukas KLECKA, Tomas REPIK, Vladimir SIGUT, Ales TOMEK, David HLINOVSKY, Daniel SANAK, Oldrich VYSATA and Martin VALIS

Edition

Biomedicines, Basel, MDPI, 2024, 2227-9059

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30230 Other clinical medicine subjects

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

STROKE

Impact factor

Impact factor: 4.700 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.3390/biomedicines12020404

UT WoS

001175025400001

Keywords (in Czech)

stroke; posterior circulation; anterior circulation; intravenous thrombolysis; intracerebral hemorrhage; clinical outcome

Keywords in English

stroke; posterior circulation; anterior circulation; intravenous thrombolysis; intracerebral hemorrhage; clinical outcome

Abstract

V originále

The safety and efficacy of intravenous thrombolysis (IVT) are well established in anterior circulation stroke (ACS) but are much less clear for posterior circulation stroke (PCS). The aim of this study was to evaluate the occurrence of parenchymal hematoma (PH) and 3-month clinical outcomes after IVT in PCS and ACS. In an observational, cohort multicenter study, we analyzed data from ischemic stroke patients treated with IVT prospectively collected in the SITS (Safe Implementation of Treatments in Stroke) registry in the Czech Republic between 2004 and 2018. Out of 10,211 patients, 1166 (11.4%) had PCS, and 9045 (88.6%) ACS. PH was less frequent in PCS versus ACS patients: 3.6 vs. 5.9%, odds ratio (OR) = 0.594 in the whole set, 4.4 vs. 7.8%, OR = 0.543 in those with large vessel occlusion (LVO), and 2.2 vs. 4.7%, OR = 0.463 in those without LVO. At 3 months, PCS patients compared with ACS patients achieved more frequently excellent clinical outcomes (modified Rankin scale [mRS] 0-1: 55.5 vs. 47.6%, OR = 1.371 in the whole set and 49.2 vs. 37.6%, OR = 1.307 in those with LVO), good clinical outcomes (mRS 0-2: 69.9 vs. 62.8%, OR = 1.377 in the whole set and 64.5 vs. 50.5%, OR = 1.279 in those with LVO), and had lower mortality (12.4 vs. 16.6%, OR = 0.716 in the whole set and 18.4 vs. 25.5%, OR = 0.723 in those with LVO) (p < 0.05 in all cases). In PCS versus ACS patients, an extensive analysis showed a lower risk of PH both in patients with and without LVO, more frequent excellent and good clinical outcomes, and lower mortality 3 months after IVT in patients with LVO.

Links

90249, large research infrastructures

Name: CZECRIN IV

Citovat

HALUSKOVA, Simona, Roman HERZIG, Robert MIKULÍK, Silvie BELASKOVA, Martin REISER, Lubomir JURAK, Daniel VACLAVIK, Michal BAR, Lukas KLECKA, Tomas REPIK, Vladimir SIGUT, Ales TOMEK, David HLINOVSKY, Daniel SANAK, Oldrich VYSATA and Martin VALIS. Intravenous Thrombolysis in Posterior versus Anterior Circulation Stroke: Clinical Outcome Differs Only in Patients with Large Vessel Occlusion. Biomedicines. Basel: MDPI, 2024, vol. 12, No 2, p. 1-13. ISSN 2227-9059. Available from: https://dx.doi.org/10.3390/biomedicines12020404.

@article{2418743,
   author = {Haluskova, Simona and Herzig, Roman and Mikulík, Robert and Belaskova, Silvie and Reiser, Martin and Jurak, Lubomir and Vaclavik, Daniel and Bar, Michal and Klecka, Lukas and Repik, Tomas and Sigut, Vladimir and Tomek, Ales and Hlinovsky, David and Sanak, Daniel and Vysata, Oldrich and Valis, Martin},
   article_location = {Basel},
   article_number = {2},
   doi = {http://dx.doi.org/10.3390/biomedicines12020404},
   keywords = {stroke; posterior circulation; anterior circulation; intravenous thrombolysis; intracerebral hemorrhage; clinical outcome},
   language = {eng},
   issn = {2227-9059},
   journal = {Biomedicines},
   title = {Intravenous Thrombolysis in Posterior versus Anterior Circulation Stroke: Clinical Outcome Differs Only in Patients with Large Vessel Occlusion},
   url = {https://www.mdpi.com/2227-9059/12/2/404},
   volume = {12},
   year = {2024}
}

TY  - JOUR
ID  - 2418743
AU  - Haluskova, Simona - Herzig, Roman - Mikulík, Robert - Belaskova, Silvie - Reiser, Martin - Jurak, Lubomir - Vaclavik, Daniel - Bar, Michal - Klecka, Lukas - Repik, Tomas - Sigut, Vladimir - Tomek, Ales - Hlinovsky, David - Sanak, Daniel - Vysata, Oldrich - Valis, Martin
PY  - 2024
TI  - Intravenous Thrombolysis in Posterior versus Anterior Circulation Stroke: Clinical Outcome Differs Only in Patients with Large Vessel Occlusion
JF  - Biomedicines
VL  - 12
IS  - 2
SP  - 1-13
EP  - 1-13
PB  - MDPI
SN  - 22279059
KW  - stroke
KW  - posterior circulation
KW  - anterior circulation
KW  - intravenous thrombolysis
KW  - intracerebral hemorrhage
KW  - clinical outcome
UR  - https://www.mdpi.com/2227-9059/12/2/404
N2  - The safety and efficacy of intravenous thrombolysis (IVT) are well established in anterior circulation stroke (ACS) but are much less clear for posterior circulation stroke (PCS). The aim of this study was to evaluate the occurrence of parenchymal hematoma (PH) and 3-month clinical outcomes after IVT in PCS and ACS. In an observational, cohort multicenter study, we analyzed data from ischemic stroke patients treated with IVT prospectively collected in the SITS (Safe Implementation of Treatments in Stroke) registry in the Czech Republic between 2004 and 2018. Out of 10,211 patients, 1166 (11.4%) had PCS, and 9045 (88.6%) ACS. PH was less frequent in PCS versus ACS patients: 3.6 vs. 5.9%, odds ratio (OR) = 0.594 in the whole set, 4.4 vs. 7.8%, OR = 0.543 in those with large vessel occlusion (LVO), and 2.2 vs. 4.7%, OR = 0.463 in those without LVO. At 3 months, PCS patients compared with ACS patients achieved more frequently excellent clinical outcomes (modified Rankin scale [mRS] 0-1: 55.5 vs. 47.6%, OR = 1.371 in the whole set and 49.2 vs. 37.6%, OR = 1.307 in those with LVO), good clinical outcomes (mRS 0-2: 69.9 vs. 62.8%, OR = 1.377 in the whole set and 64.5 vs. 50.5%, OR = 1.279 in those with LVO), and had lower mortality (12.4 vs. 16.6%, OR = 0.716 in the whole set and 18.4 vs. 25.5%, OR = 0.723 in those with LVO) (p < 0.05 in all cases). In PCS versus ACS patients, an extensive analysis showed a lower risk of PH both in patients with and without LVO, more frequent excellent and good clinical outcomes, and lower mortality 3 months after IVT in patients with LVO.
ER  -

HALUSKOVA, Simona, Roman HERZIG, Robert MIKULÍK, Silvie BELASKOVA, Martin REISER, Lubomir JURAK, Daniel VACLAVIK, Michal BAR, Lukas KLECKA, Tomas REPIK, Vladimir SIGUT, Ales TOMEK, David HLINOVSKY, Daniel SANAK, Oldrich VYSATA and Martin VALIS. Intravenous Thrombolysis in Posterior versus Anterior Circulation Stroke: Clinical Outcome Differs Only in Patients with Large Vessel Occlusion. \textit{Biomedicines}. Basel: MDPI, 2024, vol.~12, No~2, p.~1-13. ISSN~2227-9059. Available from: https://dx.doi.org/10.3390/biomedicines12020404.

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