{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:06:37Z","timestamp":1788941197477,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Intravenous thrombolysis (IVT) before thrombectomy for ischemic stroke may alter clot structure and procedural performance. We investigated how IVT relates to thrombectomy metrics across stroke etiologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a time\u2010to\u2010event analysis of consecutive patients with anterior circulation large vessel occlusion (acLVO) stroke from a prospective thrombectomy registry at a German tertiary stroke center (January 2017\u2013January 2023). The associations between IVT and groin\u2010to\u2010recanalization time and number of aspiration attempts were assessed using multivariable stratified Cox regression adjusted for demographic, cardiovascular, and stroke\u2010related variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1702 patients screened, 798 (413 female [51.8%], median age 77\u2009years [66, 84; IQR]) underwent thrombectomy. IVT was administered to 395 (49.5%) patients, and successful reperfusion (mTICI \u2265\u20092b) was achieved in 680 (85.2%) patients. In non\u2010cardioembolic stroke, IVT facilitated clot removal, yielding a 40% higher likelihood of successful reperfusion at any time point compared with direct thrombectomy (aHR 1.40; 95% CI [1.08, 1.81];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and a 36% reduction of aspiration attempts (IRR\u2009=\u20090.64, 95% CI [0.50\u20130.84],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). In cardioembolic stroke, IVT did not alter the incidence of successful reperfusion during thrombectomy (aHR 1.13; 95% CI [0.92, 1.39];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.26) or the number of aspiration attempts (combined IRR\u2009\u2248\u20091.00, 95% CI [0.82\u20131.22]) but was associated with a 43% lower likelihood of successful reperfusion throughout the intervention if distal thrombus migration occurred (aHR 0.57; 95% CI [0.33, 0.96];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>IVT was associated with faster reperfusion during thrombectomy in non\u2010cardioembolic acLVO, whereas in cardioembolic stroke with distal clot migration it was associated with delayed reperfusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70370","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T04:10:25Z","timestamp":1774411825000},"page":"1893-1902","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>IV<\/scp>\n                    Thrombolysis Facilitates Interventional Reperfusion in Non\u2010Cardioembolic but Not Cardioembolic Stroke"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2808-1415","authenticated-orcid":false,"given":"Annahita","family":"Sedghi","sequence":"first","affiliation":[{"name":"Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus TUD Dresden University of Technology  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P. O.","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology, Medical Faculty and University Hospital Carl Gustav Carus TUD Dresden University of Technology  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Arndt","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus TUD Dresden University of Technology  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norma J.","family":"Diel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus TUD Dresden University of Technology  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus TUD Dresden University of Technology  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Witold H.","family":"Polanski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty and University Hospital Carl Gustav Carus TUD Dresden University of Technology  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Puetz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus TUD Dresden University of Technology  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagen B.","family":"Huttner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus TUD Dresden University of Technology  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Siepmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus TUD Dresden University of Technology  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"e440","DOI":"10.1161\/STR.0000000000000211","article-title":"Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association\/American Stroke Association","volume":"50","author":"Powers W. 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