MR CLEAN Study Findings - Thrombolysis Before Thrombectomy in Stroke Patients?Andrea Eberly, MD, MS, FAAEM examines the recently published findings of the MR CLEAN study and the role of thrombolysis in patients with acute stroke who qualify for immediate thrombectomy.
In 2019, the American Heart Association (AHA) published stroke guidelines that for the first time fully integrated both medical (thrombolysis) and surgical methods (thrombectomy) for large cerebral vessel revascularization. This has resulted in a situation where patients who meet the criteria for both treatments now receive thrombolysis AND thrombectomy.
What did the just published MR CLEAN study (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), discover with regards to the role of thrombolysis in patients with acute stroke who qualify for and have access to nearly immediate thrombectomy?
Try this case and test your knowledge of thrombolysis before thrombectomy in stroke patients.
A 73-year-old man presents to a stroke center with a 2-hour history of a large left-sided ischemic stroke in his anterior circulation.
His rapid work-up establishes that he is eligible for both thrombolysis and thrombectomy.
Both interventions are available without delay.
According to the November 2021 MR CLEAN study, how does skipping thrombolysis prior to thrombectomy in this case affect outcome?
See the Answer:
Dr. Andrea Eberly is one of the seasoned medical experts that contribute to Med-Challenger Medical Education products for medical board certification exam preparation, maintenance of medical certification, and continuing medical education requirements.
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