Administering a bridging blood thinning drug before removing a clot is still recommended for most patients with large-vessel occlusion pending results of randomised controlled trials. However, in patients with basilar artery occlusion who undergo mechanical thrombectomy, it is not clear whether or not prior treatment with a bridging blood thinning drug is beneficial. The research team wanted to compare the clinical outcomes of mechanical thrombectomy, with and without bridging intravenous thrombolysis, in acute basilar artery occlusion through a systematic review and meta-analysis of the current literature.
The study found that in patients with acute ischemic stroke due to basilar artery occlusion, compared with direct mechanical thrombectomy, bridging intravenous thrombolysis is associated with lower mortality rates at 90 days without an increased risk of bleeding. Bridging intravenous thrombolysis is also associated with better functional outcomes particularly in patients with large atherosclerosis, which is the build-up of fatty material inside arteries. It's a potentially serious condition that causes most heart attacks and strokes but often goes unnoticed.
Paper: ‘Bridging thrombolysis improves survival rates at 90 days compared with direct mechanical thrombectomy alone in acute ischemic stroke due to basilar artery occlusion: a systematic review and meta-analysis of 1,096 patients’ by Keng Siang Lee et al. in the Journal of NeuroInterventional Surgery.