Matteo Foschi: Can Thrombolysis Safely Treat Stroke After Cardiac Procedures?
Matteo Foschi, Senior Consultant Neurologist at Romagna Local Health Authority (AUSL Romagna), shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Therapeutic Advances in Neurological Disorders, adding:
“Acute ischemic stroke following interventional cardiac procedures: can thrombolysis be a safe and effective option?
Check out our newly published systematic review in Therapeutic Advances in Neurological Disorders Sage:
‘Intravenous and intra-arterial thrombolysis for acute ischemic stroke following interventional cardiac procedures: A systematic review and narrative synthesis’
Stroke occurring during or shortly after cardiac interventions represents a particularly challenging scenario, where the potential benefits of reperfusion must be balanced against recent anticoagulation, antiplatelet exposure, and vascular access-related bleeding risks.
What did we find?
- 24 studies involving 85 thrombolysis-treated patients, highlighting how limited the available evidence remains.
- 61.1% achieved functional independence (mRS 0–2) at approximately 90 days (11/18 patients with available data).
- 76.7% experienced neurological improvement or recovery (33/43 patients with available data).
- 2.9% experienced symptomatic intracranial haemorrhage (1/35), while major or clinically significant bleeding was reported in 9.4% (8/85).
Although encouraging neurological outcomes have been reported, the evidence remains highly fragmented, largely based on case reports and small series. These findings cannot establish the effectiveness or safety of thrombolysis in this setting.
And this is exactly where our current research effort comes in!
We are now moving forward with the CLOT Study (CardioLogical Interventions and Acute strOke Treatment sTudy) — ClinicalTrials.gov:
The retrospective phase has now been completed, and the first results are coming soon!
We hope CLOT will help address some of the important evidence gaps identified in our review and support better-informed clinical decisions at the intersection of interventional cardiology and stroke medicine.”
Title: Intravenous and intra-arterial thrombolysis for acute ischemic stroke following interventional cardiac procedures: A systematic review and narrative synthesis
Authors: Lucio D’Anna, Gabriele Prandin, Samir Abu-Rumeileh, Francesco Favruzzo, Andrea Surcinelli, Renato Simonetti, Raffaele Ornello, Paola Colantuono, Simona Sacco, Francesco Di Sante, Martina Di Pietro, Stefano Luca Sensi, Valentina Tomassini, Stefano Strano, Danilo Toni, Ludovica Maria Miserocchi, Giorgia Balducci, Maria Grazia Piacaglia, Markus Otto, Robert Simister, Massimo Caulo, Marco Zimarino, Thomas Raphael Meinel, Eleni Korompoki, Roland Veltkamp, Francesco Bax, Mariariosaria Valente, Gianluigi Gigli, Giovanni Merlino, Michele Russo, Matteo Foschi
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