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ESOC 2023 | Impact of intra-arterial thrombolysis on delayed reperfusion after incomplete thrombectomy

Adnan Mujanovic, MD, PhD candidate, Inselspital, Bern University Hospital, Bern, Switzerland, discusses a study looking at delayed reperfusion rates in patients who received intra-arterial thrombolysis (IAT) for incomplete reperfusion after mechanical thrombectomy (MT). Numerous previous trials (ProACT1, ProACT2, MELT, and CHOICE) have assessed adjunct intra-arterial thrombolysis, but none have focused on delayed reperfusion. Approximately 10% of patients in their registry received additional IAT due to incomplete reperfusion post-MT. Results indicated that patients receiving IAT were more likely to develop delayed reperfusion rather than persistent perfusion deficits, compared to those who did not receive IAT. This highlights the need for studies focusing on the impact of additional reperfusion efforts over an extended period, as their value might not be fully apparent with early reperfusion analysis alone. As a next step, Dr Mujanovic and team will be running the multicenter, randomized, controlled TECNO trial, investigating tenecteplase versus best medical treatment as an additional reperfusion effort for incomplete mechanical thrombectomy, with enrollment currently underway. This interview took place during the European Stroke Organisation Conference (ESOC) in Munich, Germany.

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