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ESOC 2022 | Questions remain regarding bridging thrombolysis for ischemic stroke

Permesh Singh Dhillon, BMedSci, BMBS, FRCR, Nottingham University Hospitals NHS Trust, Nottingham, UK, discusses the use of bridging intravenous thrombolysis (IVT) prior to mechanical thrombectomy (MT), compared to direct MT alone, a major ongoing debate in the stroke field. Data from several trials suggests that the treatment effect size of thrombectomy does not differ between those who received bridging therapy and those treated with MT alone, while others have failed to demonstrate non-inferiority of direct MT. Dr Dhillon notes that the majority of trials conducted to date have studied patients brought immediately to comprehensive stroke centers. In the drip-and-ship model, where patients are first treated with thrombolysis in a local hospital before being transferred to a comprehensive stroke center, the importance of bridging remains to be seen. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.