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JAMA Neurol: It is recommended to use recombinant t-PA thrombolysis before mechanical thrombus removal in acute stroke

 Last Update: 2021-03-21
 Source: Internet
 Author: User

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Tissue-type plasminogen activator (t-PA) can convert plasminogen into plasmin, and plasmin can degrade fibrin.

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However, only about 10% of cases undergo thrombolysis with rt-PA before transplantation.

The researchers conducted prospective observations on patients who received continuous MT treatment (from August 2018 to December 2019, obtained ethical approval from the ethics committee of the University of Würzburg, Germany, and obtained written informed consent from the patient or legal representative).

At the end of the study, a total of 57 patients were included: 25 patients received rt-PA treatment, and 32 patients did not receive rt-PA treatment (see table) .

The concentration of rt-PA/t-PA in the local brain during acute cerebral ischemia is unknown.

Local brain (rt-PA/t-PA) concentration in patients with large vessel occlusion (LVO) stroke

This measurement showed that rt-PA can reach the ischemic blood vessel even though the collateral blood flow is completely blocked during embolization, and its concentration is similar to the systemic level.

In addition, blood sampling at the distal end of the occlusion site before recanalization has another value.

References: Essig F, Kollikowski AM, Müllges W, et al.
Local Cerebral Recombinant Tissue Plasminogen Activator Concentrations During Acute Stroke.
JAMA Neurol.
Published online March 08, 2021.
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