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Neurology: Is intravenous thrombolysis possible for unruptured aneurysms?

 Last Update: 2021-12-26
 Source: Internet
 Author: User

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Intravenous thrombolysis (IV thrombolysis, IVT) has become the main method for the treatment of acute ischemic stroke (AIS)
.

However, not all patients with AIS are suitable for IVT

Intravenous thrombolysis (IV thrombolysis, IVT) has become the main method for the treatment of acute ischemic stroke (AIS)

In previous studies on IVT of UIA patients, the number of cohorts varied greatly, ranging from 8 to 42 patients

In November 2021, Jyri Juhani Virta from Finland and others announced their research results on Neurology, the purpose is to explore whether IVT causes UIA rupture and intracranial hemorrhage
.

This is a prospective cohort study of consecutive patients who received treatment at a comprehensive stroke center from 2005 to 2019
.

We evaluated the imaging reports and records of the Finnish healthcare registry and identified UIAs patients among all AIS patients receiving IVT treatment

This is a prospective cohort study of consecutive patients who received treatment at a comprehensive stroke center from 2005 to 2019

That is: First, the corresponding author (JJV) screened the formal imaging reports of all patients registered for thrombolysis to determine whether UIAs were mentioned
.

The imaging report is limited to CTA, MRA or DSA examinations performed a day before or within 7 days of IVT

That is: First, the corresponding author (JJV) screened the formal imaging reports of all patients registered for thrombolysis to determine whether UIAs were mentioned

The researchers used angiography (translator's note: should include CTA, MRA, and DSA) to analyze the aneurysm characteristics, and other brain imaging tests to analyze post-IVT ICHs

During the 15-year study period, a total of 3953 patients received IVT treatment

In the end, the author believes that IVT appears to be safe for AIS patients with cystic UIAs (including large UIAs), including UIA with a diameter of ≥10 mm
.

Anticoagulation may increase the risk of rupture in patients with large fusiform posterior circulating UIAs

In the end, the author believes that IVT appears to be safe for AIS patients with cystic UIAs (including large UIAs), including UIA with a diameter of ≥10 mm

Literature source:

Neurology.
2021 Nov 2;97(18):e1790-e1798.

doi: 10.
1212/WNL.
0000000000012771.
Epub 2021 Oct 6.

Risk of Aneurysm Rupture After Thrombolysis in Patients With Acute Ischemic Stroke and Unruptured Intracranial Aneurysms

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