Abstract
OBJECTIVE: Mechanical thrombectomy (MT) alone or with intravenous thrombolysis (IVT) avoids disabilities in patients with acute ischemic stroke. The purpose of this study is to assess the outcome in two different age groups by combined technique (simultaneous stent retriever plus syringe aspiration) following thrombolysis in anterior circulation stroke and to analyze predictive factors. MATERIALS AND METHODS: We retrospectively studied all patients ( n = 500) who had ≥ modified thrombolysis in cerebral infarction (mTICI)2b following Solitaire stent retriever MT following IVT. Patients with anterior circulation stroke were dichotomized based on whether younger or older than 50 years. We analyzed predictive factors for favorable clinical outcome and also evaluated the age-related adverse results, with focus on symptomatic intracerebral hemorrhage within 7 days, favorable outcome (modified Rankin scale [mRS] 0-2), and mortality at 3 months following procedure. RESULTS: Among a total of 500 patients, 144 patients were in the young age group (≤50 years) with a mean age of 37.10 years, and 356 patients were in the old age group (>50 years) with a mean age of 63.55 years. There was a significant association between these two groups in the etiologies, medical history, age, puncture to recanalization time, and adverse results. Similarly, patient age ≤50 years, National Institute of Health Stroke Scale score at admission < 15, Alberta Stroke Program Early CT Score >5, mTICI3, and onset to recanalization time < 4 hours were significantly predictive factors for a favorable outcome. CONCLUSION: Our study shows that the combined technique after IVT for anterior circulation stroke in large vessels is safe and effective; however, younger age has a higher rate of favorable outcome with a lower mortality rate.