Intra-arterial clot-busting medicines don’t help after stroke thrombectomy

The University of Cincinnati's Pooja Khatri, MD, spoke with TCTMD about two recent trials that found administering clot-busting medications after endovascular thrombectomy does not significantly improve outcomes for patients with acute ischemic stroke. Thrombectomy is a minimally invasive stroke procedure that uses a catheter to remove a blood clot from a blood vessel in the brain to restore blood flow.

These results come after a previous trial found a large and significant benefit in administering a medication called alteplase after successful thrombectomy.

Khatri, professor, vice chair of research and division chief in the Department of Neurology and Rehabilitation Medicine at UC's College of Medicine, associate director of the UC Gardner Neuroscience Institute and codirector of NIH StrokeNet’s National Coordinating Center, who was not involved in any of the trials, said the original trial was a smaller study that ended prematurely and included patients with a wider range of results after thrombectomy. 

These newer data “are promising in terms of a therapeutic strategy with thrombolysis to attack distal visualized clots and maybe impaired microcirculatory reperfusion, or the no-reflow phenomenon as we like to call it,” she said, adding, however, that “I’m disappointed that the potential effect isn’t bigger.”

Read the TCTMD article.

Featured photo at top of UC Health's mobile stroke unit courtesy of UC Health.