Efficacy and Safety of Intravenous Thrombolysis on Acute Branch Atheromatous Disease: A Retrospective Case–Control Study

作者：Xiangbo Wu, Yang Liu, Chuang Nie, Zhiming Kang, Qunfeng Wang, Dong Sun, Huagang Li, Yumin Liu, Bin Mei · 发表于：Frontiers in Neurology · 年份：2020 · DOI：10.3389/fneur.2020.00581 · 被引用次数：36 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Antiplatelet Therapy and Cardiovascular Diseases

Background: Poor outcome and early neurological deterioration (END) frequently occured in single subcortical infarction due to branch atheromatous disease (BAD). we evaluated whether intravenous thrombolysis (IVT) plus usual care could improve functional outcome and prevent END comparing to usual care alone in single subcortical infarction related to BAD. Methods: This study analyzed retrospectively data from consecutive patients with BAD-related stroke from January 2015 to August 2019. Those patients who met the inclusion criteria were divided into two groups according to whether received IVT or not : tPA group and No-tPA group. The primary outcome was the adjusted common odds ratio for categorical shift in the distribution of the modified Rankin Scale scores (mRS) at 3 months by fitting an ordinal logistic regression, adjusted for severity of symptoms. Results: Of 618 patients with BAD-related stroke during study period, 129 patients (88 of 129 [68.2%] men) with a mean (SD) age of 62(13) years were finally enrolled in our study: 50 in the tPA group and 79 in the non-tPA group. The tPA group had a higher NIHSS score on admission(median,7 points vs 4 points; P＜0.001), lower NIHSS score at discharge (median, 2 points vs 4 points; P=0.005), and shorter hospital stays (median, 9 days vs 11 days; P=0.004) than control group. An ordinal logistic regression demonstrated a significant shift in mRS scores at 3 months in favor of intravenous thrombolysis; adjusted common odds ratio (O...