{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T13:21:17Z","timestamp":1758979277490},"reference-count":15,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2012,5,7]]},"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>The optimal management of stroke patients who fail treatment with intravenous recombinant tissue plasminogen activator (rt-PA) remains unknown. A study was undertaken to establish whether treatment with a standard intravenous t-PA dose (0.9\u2005mg\/kg) followed by multimodal endovascular therapy would have a similar safety profile to reduced dose (0.6\u2005mg\/kg) bridging therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was performed of a prospectively collected database. All patients treated with full-dose t-PA and endovascular therapy were included. The primary safety endpoints included ECASS-III symptomatic intracranial hemorrhage (sICH) and ECASS parenchymal hematomas (PH). Secondary safety endpoints included severe systemic bleeding and 90-day mortality. Clinical efficacy endpoints included rates of recanalization (TICI 2\u20133), ambulation at hospital discharge and 90-day independent outcomes (mRS 0\u20132).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>106 consecutive patients (mean age 69\u00b117\u2005years; mean baseline NIH Stroke Scale 17.8\u00b14.8; 55% women; occlusion sites: MCA-M1 60.4%; MCA-M2 6.6%; ICA-T 19.8%; tandem cervical ICA+MCA-M1 7.5%; basilar artery 5.7%) were identified over a 10-year period. The sICH rate was 8.5% and the PH-1, PH-2 and subarachnoid hemorrhage rates were 2.8%, 8.5% and 2.8%, respectively. There were two (1.9%) severe groin hematomas. The recanalization rate was 66%. At hospital discharge, 41.4% of the patients were ambulatory. The rate of independent functional outcomes at 90\u2005days was 24%; however, this sample is biased since nearly all deaths were captured but detailed 90-day functional outcomes were missing in 27 patients. The 90-day death rate was 32.4%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combined treatment with full-dose intravenous rt-PA followed by multimodal endovascular therapy seems to be associated with similar rates of sICH to that of bridging therapy with reduced rt-PA dosage.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2012-010376","type":"journal-article","created":{"date-parts":[[2012,6,17]],"date-time":"2012-06-17T21:21:36Z","timestamp":1339968096000},"page":"298-301","source":"Crossref","is-referenced-by-count":10,"title":["Safety of full-dose intravenous recombinant tissue plasminogen activator followed by multimodal endovascular therapy for acute ischemic stroke"],"prefix":"10.1136","volume":"5","author":[{"given":"Raul G","family":"Nogueira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert J","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shihab","family":"Masrur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo M","family":"Batista","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reza","family":"Hakimelahi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua A","family":"Hirsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee H","family":"Schwamm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,6,15]]},"reference":[{"key":"2024052223513987000_5.4.298.1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.12.2598"},{"key":"2024052223513987000_5.4.298.2","doi-asserted-by":"crossref","first-page":"2552","DOI":"10.1161\/01.STR.31.11.2552","article-title":"Combined intravenous and intra-arterial recombinant tissue plasminogen activator in acute ischemic stroke","volume":"31","author":"Ernst","year":"2000","journal-title":"Stroke"},{"key":"2024052223513987000_5.4.298.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000121641.77121.98"},{"key":"2024052223513987000_5.4.298.4","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1212\/01.WNL.0000149529.78396.B0","article-title":"Combined IV and intra-arterial thrombolysis for acute ischemic stroke","volume":"64","author":"Flaherty","year":"2005","journal-title":"Neurology"},{"key":"2024052223513987000_5.4.298.5","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.483131"},{"key":"2024052223513987000_5.4.298.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2007.12.004"},{"key":"2024052223513987000_5.4.298.7","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1012"},{"key":"2024052223513987000_5.4.298.8","doi-asserted-by":"publisher","DOI":"10.1161\/hs0102.101900"},{"key":"2024052223513987000_5.4.298.9","first-page":"1470","article-title":"Sequential combination of intravenous recombinant tissue plasminogen activator and intra-arterial urokinase in acute ischemic stroke","volume":"25","author":"Lee","year":"2004","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052223513987000_5.4.298.10","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000251720.25337.b0"},{"key":"2024052223513987000_5.4.298.11","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.497115"},{"key":"2024052223513987000_5.4.298.12","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1236"},{"key":"2024052223513987000_5.4.298.13","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.592535"},{"key":"2024052223513987000_5.4.298.14","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.609693"},{"key":"2024052223513987000_5.4.298.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2009.00441.x"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2012-010376","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T08:25:13Z","timestamp":1716452713000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2012-010376"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,6,15]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2013,6,11]]},"published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1136\/neurintsurg-2012-010376"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2012-010376","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,6,15]]}}}