To the Editor:Acute large vessel occlusion(LVO)is responsible for most acute ischemic stroke(AIS),a common cause of disability and death worldwide.Randomized controlled clinical trials(RCTs)provided evidence endorsing...To the Editor:Acute large vessel occlusion(LVO)is responsible for most acute ischemic stroke(AIS),a common cause of disability and death worldwide.Randomized controlled clinical trials(RCTs)provided evidence endorsing intravenous thrombolysis(IVT,also termed bridging therapy[IVT])and endovascular thrombectomy over IVT alone as the current standard treatment for people with LVO in the anterior circulation.[1]The current American and European guidelines recommend using IVT for all eligible individuals with LVO before direct mechanical thrombectomy(d-MT)(class of recommendation-I).Recent RCTs suggest that MT was noninferior to BT in terms of efficacy and safety,[2,3]which contradict the results from multiple meta-analyses favoring BT over d-MT.[4]The benefit of routine IVT for eligible individuals before thrombectomy has become controversial.BT is associated with complications,including the risk of vasospasm,distal emboli,or symptomatic intracranial hemorrhage.展开更多
文摘To the Editor:Acute large vessel occlusion(LVO)is responsible for most acute ischemic stroke(AIS),a common cause of disability and death worldwide.Randomized controlled clinical trials(RCTs)provided evidence endorsing intravenous thrombolysis(IVT,also termed bridging therapy[IVT])and endovascular thrombectomy over IVT alone as the current standard treatment for people with LVO in the anterior circulation.[1]The current American and European guidelines recommend using IVT for all eligible individuals with LVO before direct mechanical thrombectomy(d-MT)(class of recommendation-I).Recent RCTs suggest that MT was noninferior to BT in terms of efficacy and safety,[2,3]which contradict the results from multiple meta-analyses favoring BT over d-MT.[4]The benefit of routine IVT for eligible individuals before thrombectomy has become controversial.BT is associated with complications,including the risk of vasospasm,distal emboli,or symptomatic intracranial hemorrhage.
