2026-04-13T03:01:05Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/138682025-10-24T10:38:30Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Beyeler, Morin
author
Rohner, Roman
author
cognard, christophe
author
bourcier, romain
author
Ijäs, Petra
author
Eker, Omer, Faruk
author
Ribo, Marc
2025-10-24T10:38:30Z
2025-10-24T10:38:30Z
2025-10-16T06:26:17Z2025-10-16T06:26:17Z2025-09
http://hdl.handle.net/11351/13868
Intravenous alteplase; Ischemic stroke; Susceptibility vessel signAlteplasa intravenosa; Ictus isquémico; Señal de vaso de susceptibilidadAlteplasa intravenosa; Ictus isquèmic; Senyal de vas de susceptibilitatBackground
The susceptibility vessel sign (SVS) on baseline MRI in acute ischemic stroke patients has been associated with better outcomes post-thrombectomy. This study aimed to investigate whether the presence of the SVS modifies the treatment effect of intravenous thrombolysis plus endovascular thrombectomy (IVT + EVT) versus thrombectomy alone (EVT alone).
Methods
In this secondary analysis of the SWIFT DIRECT trial, comparing IVT + EVT versus EVT alone, treatment effect and its heterogeneity were assessed with rates of pre-interventional reperfusion (eTICI 2a–3) and successful post-interventional reperfusion (eTICI of 2b–3) according to the SVS status using adjusted multivariable logistic regression. Secondary objectives were to analyze whether the presence of SVS or its individual characteristics (location, length, width, overestimation ratio, two-layered sign) were associated with outcomes.
Results
197 of the initial 408 trial participants were included in this secondary analysis, of which 52% received IVT + EVT. SVS was present in 92% of the participants (n = 181). There was no evidence for treatment effect heterogeneity regarding the post-interventional radiological and clinical effects of IVT + EVT versus EVT alone with strata of SVS. In SVS+ participants, IVT favored pre-interventional reperfusion (aOR 7.95, 95% CI 1.42–44.46), whereas in SVS-patients, it did not (P for interaction = 0.02). The individual SVS characteristics showed no significant associations with outcomes.
Conclusion
Presence of SVS does not seem to modify the effect of IVT + EVT versus EVT alone. In SVS+ patients, IVT might improve pre-interventional reperfusion. There is insufficient evidence to recommend using SVS to inform IVT decisions prior to EVT.Open access funding provided by University of Bern.
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Malalties cerebrovasculars - Tractament
Fibrinolítics - Ús terapèutic
Vasos sanguinis - Cirurgia
Imatgeria per ressonància magnètica
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Vascular Surgical Procedures::Thrombectomy
DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke
Other subheadings::Other subheadings::/therapy
CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Fibrin Modulating Agents::Fibrinolytic Agents
Other subheadings::Other subheadings::Other subheadings::/administration & dosage
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Tomography::Magnetic Resonance Imaging
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos cardiovasculares::procedimientos quirúrgicos vasculares::trombectomía
ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular
Otros calificadores::Otros calificadores::/terapia
COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::mecanismos moleculares de acción farmacológica::moduladores de la fibrina::fibrinolíticos
Otros calificadores::Otros calificadores::Otros calificadores::/administración & dosificación
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::tomografía::imagen por resonancia magnética
Susceptibility Vessel Sign and Intravenous Alteplase in Stroke Patients Treated with Thrombectomy : A Secondary Analysis of the SWIFT DIRECT Trial
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion