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06-11-2023 | Stroke | Original Article

Effects of immediate thrombolytic treatment in imaging area on functional outcome in patients with acute ischemic stroke

Authors: Antonio De Mase, Emanuele Spina, Giovanna Servillo, Stefano Barbato, Giuseppe Leone, Flavio Giordano, Massimo Muto, Gianluigi Guarnieri, Gennaro Alfieri, Katia Longo, Walter Di Iorio, Mario Muto, Paolo Candelaresi, Vincenzo Andreone

Published in: Neurological Sciences | Issue 4/2024

Abstract

Introduction

Door-to-needle time (DNT) is an established predictor of outcome in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT). Several strategies have been proposed to streamline in-hospital pathways, among which treatment at CT/MR bed.

Aim

To explore the impact of treatment at CT/MR bed, here defined as imaging area (IA), on functional outcome in stroke patients treated with IVT alone.

Methods

All AIS patients treated with IVT alone at our center in 2020, 2021, and 2022 were included. Patients with any previous disability were excluded. The cohort was divided into two groups, depending on the treatment site. One group received IVT at IA, the other at emergency room or stroke unit (non-IA). Regression analysis assessed the association between treatment site and 3-month outcome.

Results

A total of 327 patients who received IVT alone were included in the analysis. One hundred thirty-three (40.7%) were in the IA group and 194 (59.3%) in the non-IA group. The groups showed similar baseline characteristics. In the IA group, DNT was 45 min shorter. Despite similar rates of functional independence (mRS 0-2), the IA group showed higher rates of excellent outcome (mRS 0-1) compared to the non-IA group (60.1% vs 42.8%, p<0.01). Immediate treatment at IA was independently associated to excellent outcome (OR 1.78 [1.03–3.08]).

Conclusions

Thrombolytic treatment at IA lowers DNT and is an independent predictor of excellent outcome after AIS. Our study emphasizes the importance of immediate thrombolytic treatment at IA, soon after radiological eligibility is confirmed. Immediate treatment at IA should be a standard-of-care for AIS.

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Title: Effects of immediate thrombolytic treatment in imaging area on functional outcome in patients with acute ischemic stroke
Authors: Antonio De Mase
Emanuele Spina
Giovanna Servillo
Stefano Barbato
Giuseppe Leone
Flavio Giordano
Massimo Muto
Gianluigi Guarnieri
Gennaro Alfieri
Katia Longo
Walter Di Iorio
Mario Muto
Paolo Candelaresi
Vincenzo Andreone
Publication date: 06-11-2023
Publisher: Springer International Publishing
Keyword: Stroke
Published in: Neurological Sciences / Issue 4/2024
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-023-07166-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of immediate thrombolytic treatment in imaging area on functional outcome in patients with acute ischemic stroke

Abstract

Introduction

Aim

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Aim

Methods

Results

Conclusions

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