International journal of stroke : official journal of the International Stroke Society
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Clinical outcome after large-vessel occlusive strokes depends on admitting clinical condition, successful recanalization, and robust collateral circulation. However, predicting successful recanalization and quantifying collateral status in the acute setting remain elusive. Successful recanalization has many predictive factors. ⋯ Patients with large-vessel occlusive strokes have variable clinical responses to fibrinolysis and thrombectomy. Independent predictive variables that can possibly alter clinical outcome appear to be successful recanalization and robust collateral circulation. Future studies that allow for better prediction of successful recanalization and quantification of collateral status may help clinical decision-making when evaluating large-vessel occlusions.
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There is uncertainty surrounding the influence of prior antiplatelet agent use on outcomes after intravenous thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke. ⋯ In acute ischemic stroke patients receiving intravenous recombinant tissue plasminogen activator therapy, prior antiplatelet agent use did not lead to a significant difference in functional outcome, although it significantly increased the risk of symptomatic intracranial hemorrhage. Recanalization rate was not different between two groups. In the subgroup analysis, prior clopidogrel mono therapy may not increase the risk of symptomatic intracranial hemorrhage, which will need further studies to confirm.
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There is uncertainty surrounding the influence of prior antiplatelet agent use on outcomes after intravenous thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke. ⋯ In acute ischemic stroke patients receiving intravenous recombinant tissue plasminogen activator therapy, prior antiplatelet agent use did not lead to a significant difference in functional outcome, although it significantly increased the risk of symptomatic intracranial hemorrhage. Recanalization rate was not different between two groups. In the subgroup analysis, prior clopidogrel mono therapy may not increase the risk of symptomatic intracranial hemorrhage, which will need further studies to confirm.
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Review Meta Analysis
Outcomes after stroke thrombolysis according to prior antiplatelet use.
Thirty percent of ischemic stroke (IS) patients suffering from acute stroke are under antiplatelet therapy. ⋯ These results suggest no significant detrimental effect of prior antiplatelet use in AIS patients treated by IV, IA or combined IV/IA therapy. Further studies are needed to assess the specific impact of different and cumulative antiplatelet agents.
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Review Meta Analysis
Outcomes after stroke thrombolysis according to prior antiplatelet use.
Thirty percent of ischemic stroke (IS) patients suffering from acute stroke are under antiplatelet therapy. ⋯ These results suggest no significant detrimental effect of prior antiplatelet use in AIS patients treated by IV, IA or combined IV/IA therapy. Further studies are needed to assess the specific impact of different and cumulative antiplatelet agents.