{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:16:36Z","timestamp":1791357396345,"version":"4.3.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,16]],"date-time":"2018-04-16T00:00:00Z","timestamp":1523836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Endovascular treatment (<jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content>), in addition to a therapy with intravenous recombinant tissue plasminogen activator <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> in patients with acute ischemic stroke, has been found to improve outcome. However, data about <jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content> in patients who have not received therapy with rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> due to contraindications for <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> are sparse. Comparison of <jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> versus <jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content> alone in patients with stroke is done using a proximal intracranial arterial occlusion (internal carotid artery, middle cerebral artery (M1\u2010Segment)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>During a 5\u2010year period (2011\u20132016), 236 patients (mean age, 69\u00a0\u00b1\u00a014\u00a0years; 46% women; median <jats:styled-content style=\"fixed-case\">NIHSS<\/jats:styled-content> score 13\u00a0\u00b1\u00a05) who were treated at the Department of Neurology and Neuroradiology at the University of L\u00fcbeck, undergoing <jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content> with or without <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> were included and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 144 patients (61%) underwent <jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>, and 92 patients (39%) underwent <jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content> only. The <jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> is associated with a higher rate of favorable functional outcomes (<jats:styled-content style=\"fixed-case\">mRS<\/jats:styled-content>\u22642) at discharge from hospital (51.4% vs. 23.1%, <jats:italic>p\u00a0&lt;\u00a0<\/jats:italic>.001) and lower rate of in\u2010hospital mortality (9% vs. 19.6%, <jats:italic>p\u00a0=\u00a0<\/jats:italic>.019) and symptomatic intracerebral hemorrhage [<jats:styled-content style=\"fixed-case\">sICH<\/jats:styled-content>] (2.1% vs. 8.7%; <jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.019) compared to <jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content>, whereas the modified treatment in cerebral infarction score (<jats:styled-content style=\"fixed-case\">mTICI<\/jats:styled-content>) did not differ between the groups.<\/jats:p><jats:p>In the adjusted logistic regression analysis, the <jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> was associated with an increased probability of favorable functional outcome (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 4.3; 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>], 2.2\u20138.5; <jats:italic>p\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>.001). For the in\u2010hospital mortality (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.74; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.29\u20131.9; <jats:italic>p\u00a0=\u00a0<\/jats:italic>.76) and <jats:styled-content style=\"fixed-case\">sICH<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.3; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.07\u20131.2; <jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.09), no differences were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Recanalization results after endovascular treatment are not relevantly improved in patients receiving rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>. However, an additional therapy with <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> has a positive impact on functional outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.974","type":"journal-article","created":{"date-parts":[[2018,4,16]],"date-time":"2018-04-16T15:50:21Z","timestamp":1523893821000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparing outcome and recanalization results in patients with anterior circulation stroke following endovascular treatment with and without a treatment with rt\u2010<scp>PA<\/scp>: A single\u2010center study"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8406-5044","authenticated-orcid":false,"given":"Mohamed","family":"Al\u2010Khaled","sequence":"first","affiliation":[{"name":"Department of Neurology University of L\u00fcbeck  L\u00fcbeck 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