Home > Neurology > AAN 2022 > Cerebrovascular Disease and Stroke > Intravenous thrombolysis after ischaemic stroke: When in doubt, leave it out?

Intravenous thrombolysis after ischaemic stroke: When in doubt, leave it out?

Presented By
Dr Natalie LeCouffe, Amsterdam University Medical Centre, the Netherlands
Presented by
Natalie LeCouffe Amsterdam University Medical Centre
Conference
AAN 2022
Trial
Phase 3, MR CLEAN-NO IV
Doi
https://doi.org/10.55788/65b37c1f
Results of the MR CLEAN-NO IV trial failed to show superiority (or non-inferiority) of direct endovascular treatment (EVT) compared with the combination of intravenous thrombolysis (IVT) and EVT. Does this imply guidelines need to be revised? The publication of the original MR CLEAN trial established mechanical thrombectomy as a safe and effective treatment for acute ischaemic stroke caused by large-vessel occlusion [1]. IVT in eligible patients prior to EVT is still recommended, most notably in the guidelines of the European Stroke Organisation (ESO)–European Society for Minimally Invasive Neurological Therapy (ESMINT) [2]. This may however not be necessary. To bring more certainty, MR CLEAN-NO IV was carried out in 20 centres (16 in the Netherlands) capable of providing EVT. Dr Natalie LeCouffe (Amsterdam University Medical Centre, the Netherlands) presented the results [3,4]. The phase 3 MR


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