Article Figures & Data
Figures
- Fig 1.
Graph shows the distribution of admission NIHSS scores for patients in each group displayed in a relative-frequency histogram. Black bars indicate patients who received IV rtPA but no endovascular intervention. Gray bars indicate patients who received IV rtPA followed by endovascular intervention. Mean NIHSS scores at admission were not different between the 2 groups (P = .822).
- Fig 2.
Graph shows the distribution of NIHSS scores at follow-up for patients in each group, displayed in a relative-frequency histogram. Black bars indicate patients who received IV rtPA but no endovascular intervention. Gray bars indicate patients who received IV rtPA followed by endovascular intervention. NIHSS scores at follow-up were significantly better in patients who received IV rtPA plus endovascular intervention (P = .037).
- Fig 3.
Changes in NIHSS scores from admission to follow-up for patients, displayed in a relative-frequency histogram. Black bars indicate patients who received IV rtPA but no endovascular intervention. Gray bars indicate patients who received IV rtPA followed by endovascular intervention. Patients who worsened after admission have negative scores (toward the left), whereas patients who improved have positive scores (toward the right). Improvement in NIHSS scores is significantly higher in patients who received IV rtPA plus an endovascular intervention (P = .025).
Tables
Characteristic IV + Intervention (n = 33) IV Only (n = 30) Mean age (mean ± SD) 66.6 ± 12.0 66.4 ± 17.4 Women (%) 22 (66.7%) 21 (70.0) Mean admission NIHSS score 15.8 ± 3.5 16.0 ± 3.5 Median admission NIHSS score (median, 25%, 75%) 15 (13, 19) 16.5 (14, 18.75) Time to IV rtPA (mean ± SD) 118 ± 27.4 103.1 ± 37.1 Time to cath (mean ± SD) 239.9 ± 61.6 n/a Vascular risk factors Hypertension 25 (76%) 16 (53%) Atrial fibrillation 8 (24%) 6 (20%) Previous MI/CAD 9 (27%) 4 (23%) Congestive heart failure 5 (15%) 8 (27%) Previous stroke/TIA 6 (18%) 8 (27%) Diabetes mellitus 11 (33%) 6 (20%) Cigarette smoking history 8 (24%) 5 (17%) Race/ethnicity* White 7 (21%) 17 (57%) African American 20 (61%) 8 (27%) Hispanic 5 (15%) 4 (13%) Other/unknown 1 (3%) 1 (3%) Note:—n/a indicates not applicable; MI, myocardial infarction; CAD, coronary artery disease; TIA, transient ischemic attack; NIHSS, National Institutes of Health Stroke Scale; IV rtPA, intravenous recombinant tissue plasminogen activator.
* P = .0048.
Treatments Received No. 1st NIHSS Score FU NIHSS Score Pre-Qureshi Grade Post-Qureshi Grade Mortality (No.) IA reteplase 14 18.5 (13.25, 19.75) 7 (2, 13.5) 2 (1, 3A) 1 (0, 1.75) 2 IA reteplase only 8 17 (12.75, 22) 6.5 (2, 9.75) 1 (1, 1.25) 0 (0, 1) 0 IA reteplase + other* 6 18.5 (15, 19) 7.5 (3, 33.75) 3A (3A, 3A) 1 (0.75, 1.25) 2 MERCI Retriever 8 15 (12, 16.25) 11 (2.75, 14.25) 2 (1, 3A) 2 (1, 2.5) 1 MERCI only 3 15 (13.5, 16) 2 (1, 2.5) 1 (1, 1) 0.5 (1, 0) 0 MERCI + other 5 15 (12, 16) 13 (12, 18) 3A (2, 3B) 2 (2, 3A) 1 Snare devices 15 14 (12, 18) 10 (5, 13.5) 3A (2, 3B) 2 (1, 3A) 1 Snare only 5 17 (14, 19) 14 (4, 38) 3A (2, 3B) 2 (0, 2) 1 Snare + other 10 13 (12, 15.75) 9.5 (6.75, 11.5) 3A (2, 3A/B) 2.5 (1, 3A) 0 Acute angioplasty† 10 16 (13.5, 17.75) 10 (3.75, 20.25) 3A (2.25, 3B) 2 (0, 3A) 2 Angioplasty only 5 16 (15, 17) 2 (0, 12) 2 (1.5, 2.25) 0 (0, 0.25) 0 Angioplasty + other* 5 16 (12, 18) 10 (10, 42) 3B (3A, 3B) 3A (3A, 3A) 2 Note:—FU indicates follow-up; NIHSS, National Institutes of Health Stroke Scale.
* Includes 1 patient who received suction thrombectomy.
† Includes 1 patient who received acute stent placement.
Variable IV + Intervention IV Only P Effect Size† No. patients 33 30 Admission NIHSS score‡ (mean ± SD) 15.8 ± 3.5 16.0 ± 3.5 Admission NIHSS score (median, 25%, 75%) 15 (13, 19) 16.5 (14, 18.75) .822 0.033 Follow-up NIHSS score 8 (2, 14) 14 (11.5, 7) .037 0.535 NIHSS score improvement 9 (2, 12) 12 (3.5, −22) .025 0.575 Significance of change from admission P = .071 P = .173 ≥4 NIHSS points 22 (66.7) 15 (50%) .208 2.00 (0.72–5.53) ≥10 NIHSS points 16 (48.5%) 7 (23.3%) .066 3.09 (1.04–9.17) Favorable outcome (NIHSS scores, 0–2) 11 (33.3%) 4 (13.3%) .080 3.25 (0.91–11.66) 90-Day mortality 4 (12.1%) 12 (40.0%) .019 0.21 (0.06–0.74) Note:—NIHSS indicates National Institutes Health Stroke Scale.
* Follow-up assessment performed at day 7 or discharge for the intervention group and discharge or follow-up visit for the control group (see text).
† Effect size measured as Cohen D for continuous variables or odds ratio (95% CI) for categoric variables.
‡ Admission NIHSS scores for all patients ≥10.
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