摘要
Objective Data regarding the efficacy and safety of bridging thrombolysis(BT)initiated before transfer for evaluation of endovascular therapy is heterogeneous.We,therefore,analyse efficacy and safety of BT in patients treated within a drip-and-ship stroke service.Methods Consecutive adult patients suffering from acute ischaemic stroke and large-vessel occlusions(LVO)transferred to our comprehensive stroke centre for evaluation of endovascular therapy in 2017–2020 were identified from a local prospective stroke database and categorised according to BT and no-BT.BT was defined as intravenous thrombolysis initiated before transfer.LVO was assessed before and after transfer.Functional outcome before stroke and at 3 months using the modified Rankin scale(mRS)was determined.Excellent outcome was defined as mRS 0–1 or return to prestroke mRS.For safety analysis,intracranial haemorrhages and mortality at 3 months were analysed.Main analysis was limited to patients with anterior circulation stroke.Results Of N=714 patients,n=394(55.2%)received BT.More patients in the BT group with documented LVO before transfer recanalised without endovascular therapy(n=46,11.7%)than patients who did not receive BT before transfer(n=4,1.3%,p<0.001).In multivariate analysis,BT was the strongest independent predictor of early recanalisation(adjusted OR 10.9,95%CI 3.8 to 31.1,p<0.001).BT tended to be an independent predictor of an excellent outcome at 3 months(adjusted OR 1.38,95%CI 0.97 to 1.96,p=0.077).There were no differences in safety between the BT and no-BT groups.Conclusions BT initiated before transfer was a strong independent predictor of early recanalisation.
