Outcomes of endovascular versus intravenous thrombolytic treatment for acute ischemic stroke in dialysis patients

Fahad Saeed, Malik M. Adil, Bilal Hussain Piracha, Adnan I. Qureshi

Research output: Contribution to journalArticle

Abstract

Background and Objectives: To compare the outcomes of IV thrombolytics (tissue plasminogen activator or tPA) with endovascular treatment (intra-arterial tPA ± mechanical thrombectomy) in dialysis patients who suffered from acute ischemic stroke.

Study design: Observational study.

Setting and Participants: Data analysis from Nationwide Inpatient Sample (NIS 2005- 2010) including dialysis patients presenting with acute ischemic stroke, either treated with IV thrombolytics or endovascular treatment.

Outcomes: Baseline characteristics, in-hospital complications, and discharge outcomes were compared between the two groups. We determined the effect of endovascular treatment on in-hospital mortality, disability at discharge, and post-thrombolytic intracerebral hemorrhages (ICH) after adjusting for potential confounders using multivariate analysis.

Results: Of the 2 313 dialysis patients with ischemic stroke, 1 398 (60%) received IV thrombolytics and 915 (40%) were treated with endovascular treatment. The in-hospital mortality rate and moderateto-severe disability were lower in dialysis patients receiving endovascular treatment (7.6% vs. 14.5% p = 0.04) and (30% vs. 52% p = <.0001), respectively. After adjusting for age, gender, and potential confounders, endovascular treatment was associated with lower in-hospital mortality (OR 0.5, 95% CI 0.2-0.9) and moderate-to-severe disability (OR 0.3, 95% CI 0.2-0.5).

Conclusions: The odds of both in-hospital mortality and moderate to severe disability were lower with endovascular treatment in dialysis patients. Such data support the preferential use of endovascular treatment in this patient population.

Original languageEnglish (US)
Pages (from-to)727-733
Number of pages7
JournalInternational Journal of Artificial Organs
Volume37
Issue number10
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

    Fingerprint

Keywords

  • Dialysis
  • Endovascular treatment
  • Ischemic stroke
  • Thrombolytic treatment

ASJC Scopus subject areas

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

Cite this