Photo Credit: brgfx

The following is a summary of “Intravenous Thrombolysis in Patients With Cervical Artery Dissection: A Secondary Analysis of the STOP-CAD Study,” published in the September 2024 issue of Neurology by Shu et al.

Cervical artery dissection (CeAD) is a major cause of ischemic stroke in younger adults, accounting for 25% of cases.  

Researchers conducted a retrospective study to assess the benefits and risks of intravenous thrombolysis (IVT) in patients with spontaneous CeAD and acute ischemic stroke symptoms. 

They analyzed data from the STOP-CAD study, including 1,653 patients with spontaneous CeAD who presented within 24 hours of acute ischemic stroke symptoms. Patients were divided into 2 groups: those who received IVT and those who did not. Association between IVT and achieving functional independence (modified Rankin Scale scores 0–2) was investigated at 90 days, and symptomatic intracranial hemorrhage (ICH) within 72 hours after CeAD diagnosis.

The results showed 1,653 patients with a median age of 49 years, 35.1% women, and 512 (31.0%) received IVT.  The study found that IVT was linked with functional independence at 90 days (aOR = 1.67, 95% CI 1.23–2.28, P=0.001). However, IVT was not associated with an increased risk of symptomatic ICH (aOR = 1.52, 95% CI 0.79–2.92, P=0.215).  

They concluded that IVT improved functional outcomes in patients with spontaneous CeAD and suspected ischemic stroke without increasing symptomatic ICH risk, supporting current guideline recommendations for thrombolysis.

Source: neurology.org/doi/10.1212/WNL.0000000000209843