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Patients undergoing early endovascular therapy for stroke had similar outcomes regardless of their eligibility for IV tissue-type plasminogen activator (tPA), an observational study suggested.

At 90 days, endovascular therapy with thrombolytics to more frequent successful reperfusion than when done without tPA (83% versus 80%, P=0.52), nor were there differences in parenchymal hematoma (3% versus 5%, P=0.21) or low disability scores (45% versus 38%, P=0.21).

Unadjusted 90-day mortality was higher in the endovascular therapy-only cohort (21% versus 34%, P<0.01), although this association disappeared on logistic regression analysis due to baseline differences in age and other factors, , of Grady Memorial Hospital in Atlanta, and colleagues reported in Stroke.

Given the general exclusion of the tPA-ineligible population in trials of thrombectomy, this study "revealed that the benefit of endovascular therapy in intravenous tPA-ineligible patients seems to be comparable with those treated with intravenous tPA plus endovascular therapy," the authors wrote.

Expressing hope to add to the "scarce" literature, Nogueira's group suggested that their results will "further support the pursuit of endovascular reperfusion in intravenous tPA-ineligible patients."

The study included 422 stroke patients treated within 6 hours of stroke onset between 2010 and 2015. Individuals eligible for tPA treatment tended to be younger (P=0.05), and were less likely to have hypertension (P=0.02) and vertebrobasilar occlusions (P=0.02).

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