AUTHOR=Wang Xueqi , Zhang Hao , Wang Qi , Li Gang , Shen Hao , Xiao Yaping , Xu Luran , Long Yuming , Chen Chen , Huang Zhengyu , Zhang Yue 

TITLE=Effect of intravenous thrombolysis on core growth rate in patients with acute cerebral infarction

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1096605

DOI=10.3389/fneur.2023.1096605

ISSN=1664-2295

ABSTRACT=Objective: To investigate the effects of recombinant tissue plasminogen activator intravenous thrombolysis (IVT) on the core growth rate of acute ischemic stroke.
Methods: Stroke patients with large vessel occlusion and non-recanalization from IVT treatment were retrospectively included in this study, and divided into two groups: IVT and non-IVT. Core growth rate was estimated by the acute core volume on perfusion CT divided by the time from last-known-well to CT perfusion. The primary endpoint was core growth rate, the tissue outcome was 24h-ASPECTS score, and the clinical outcome was 3-month modified Rankin score.
Results: A total of 94 patients were included, with 53 in the IVT group and 41 in the non-IVT group. There was no significant difference in age, gender, hypertension, diabetes, atrial fibrillation, acute NIHSS score and time from last-known-well to CT perfusion acquisition between the two groups. The core growth rate in the IVT group was lower than that in the non-IVT group, which was statistically significant after multivariate adjustment (coefficient: -5.20, 95% CI= [-9.85, -0.56], p=0.028). There was a significant interaction between IVT and collateral index in predicting core growth rate. The analysis was then stratified according to collateral index, and the results suggested that IVT reduced the core growth rate more significantly after worsening of collateral circulation (coefficient: 15.38, 95% CI= [-26.25, -4.40], p=0.007). The 3-month modified Rankin score and 24h-ASPECTS score were not have statistically significant between the two groups. 
Conclusion: IVT reduces core growth rate in AIS patients, especially those with poor collateral status.