Prior IV thrombolysis does not dictate first-line thrombectomy technique
For neurology and neurointerventional pharmacists, this secondary analysis clarifies that alteplase exposure before thrombectomy should not, by itself, drive selection of aspiration versus combined stent-retriever strategies.
Does prior thrombolysis influence thrombectomy effectiveness in stroke recovery?
The impact of prior intravenous thrombolysis (IVT) on thrombectomy strategies for stroke remains uncertain, affecting clinical decision-making. In the VECTOR trial's secondary analysis, prior IVT did not significantly alter reperfusion success between thrombectomy strategies, though a slight advantage for contact aspiration (CA) was noted in non-IVT patients. Both contact aspiration and stent retriever plus contact aspiration are viable regardless of IVT use; findings are preliminary and specific to MRI-selected patients using alteplase. Prior IVT does not notably affect thrombectomy strategy outcomes, suggesting broad applicability of techniques.
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Authors:Mouyal SJ, Maïer B, Labreuche J, Desilles JP, Mazighi M, Bourcier R, Redjem H
Citation:Mouyal SJ, Maïer B, Labreuche J, et al. Impact of prior intravenous thrombolysis on first-line thrombectomy strategy. A secondary analysis of the VECTOR trial. European stroke journal. 2026;11(7). doi:10.1093/esj/aakag087