Mechanical Thrombectomy Outcomes With or Without Intravenous Thrombolysis

Insight From the ASTER Randomized Trial

Florent Gariel, MD, MSc; Bertrand Lapergue, MD, PhD; Romain Bourcier, MD, PhD; Jérôme Berge, MD; Xavier Barreau, MD; Mikael Mazighi, MD, PhD; Maéva Kyheng, BST; Julien Labreuche, BST; Robert Fahed, MD; Raphael Blanc, MD, MSc; Benjamin Gory, MD, PhD; Alain Duhamel, PhD; Suzana Saleme, MD; Vincent Costalat, MD, PhD; Serge Bracard, MD, PhD; Hubert Desal, MD, PhD; Lili Detraz, MD; Arturo Consoli, MD; Michel Piotin, MD, PhD; Gaultier Marnat, MD; for the ASTER Trial Investigators


Stroke. 2018;49(10):2383-2390. 

In This Article


Our results demonstrated that IVT+MT patients in the ASTER trial have lower 90-day mortality compared with those receiving MT alone potentially associated with a selection bias (age and comorbidities). In a subgroup analysis of patients not on anticoagulant medication before stroke onset, we demonstrate for IVT+MT patients a better functional outcome and a higher recanalization rate after the first-line strategy requiring a lower number of device passes, a lower mortality rate, and a comparable risk of hemorrhagic complications.

Our findings highlight the need for randomized trials to accurately determine the additional contribution of IVT in patients treated with MT.