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The utility of NIRS in follow-up of patients with acute ischaemic stroke treated with IV thrombolysis and mechanical thrombectomy in the emergency department

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Abstract

Revascularization treatments (IV thrombolysis, mechanical thrombectomy) related to ischemic stroke have developed in recent years. With devices such as NIRS, non-invasive monitoring of treatment efficacy is provided. In this study, we aimed to use near-infrared spectroscopy (NIRS) as an objective monitoring method to see the effect of intravenous (IV) thrombolysis or mechanical thrombectomy treatments applied for cerebral oxygenation in patients with acute ischemic stroke. This study was carried out as a prospective study involving patients admitted to the emergency department in the years 2021–2022. NIRS measured regional oxygen saturation (rSO2) of both hemispheres of the brain before IV thrombolysis treatment, during the treatment at 0. min, 15. min, 30. min, 45. min, 60. min, after the treatment, and before and after the mechanical thrombectomy procedure. The significance level of the change in rSO2 values measured by NIRS was examined. 80 patients were included in the study. IV thrombolysis was applied to 58 patients, mechanical thrombectomy was applied to 5 of them, and both treatments were applied to 17 of them. In patients receiving IV thrombolysis, a significant difference was found in the affected hemisphere between the NIRS values measured at 0.min–15.min, 0.min–30.min, 0.min–45.min, 0.min–60.min, 0.min-post-treatment, 15.min-60.min (p < 0.001). In the patients included in the study, there was a strong and significant negative correlation between the deltaNIHSS value and the deltaNIRS values in the affected hemisphere (r=− 0.307, p = 0.013). There was a significant increase in the NIRS measurement values during and after the IV thrombolysis treatment in the affected hemisphere in the group with clinical improvement (p < 0.001). It is thought that IV thrombolysis or mechanical thrombectomy treatment applied to patients admitted to the emergency department with acute ischemic stroke can be followed objectively by NIRS.

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Authors and Affiliations

  1. Department of Emergency Medicine, Rize State Hospital, 53100, Rize, Turkey

    İsmail Ataş

  2. Department of Emergency Medicine, Recep Tayyip Erdoğan University Training and Research Hospital, 53020, Rize, Turkey

    Gökhan Ersunan, Özlem Bỉlỉr, Özcan Yavaşỉ & Mehmet Altuntaş

  3. Department of Public Health, Karadeniz Technical University, 61080, Trabzon, Turkey

    Serdar Karakullukçu

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  1. İsmail Ataş
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  2. Gökhan Ersunan
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  3. Özlem Bỉlỉr
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  4. Özcan Yavaşỉ
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  5. Mehmet Altuntaş
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  6. Serdar Karakullukçu
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Correspondence to İsmail Ataş.

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Ataş, İ., Ersunan, G., Bỉlỉr, Ö. et al. The utility of NIRS in follow-up of patients with acute ischaemic stroke treated with IV thrombolysis and mechanical thrombectomy in the emergency department. J Thromb Thrombolysis 57, 466–472 (2024). https://doi.org/10.1007/s11239-023-02920-9

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