Intra-arterial or intravenous thrombolysis for acute ischemic stroke? The SYNTHESIS pilot trial

A. Ciccone, L. Valvassori, M. Ponzio, E. Ballabio, R. Gasparotti, M. Sessa, F. Scomazzoni, P. Tiraboschi, R. Sterzi, A. Ciccone, L. Candelise, G. Del Zoppo, P. Sandercock, E. Ballabio, T. Cantisani, C. Coppola, M. Ponzio, A. Ciccone, A. Gatti, A. GuccioneI. Santilli, R. Sterzi, S. Jann, A. Protti, M. Rizzone, E. Boccardi, L. Valvassori, M. Guidotti, N. Checcarelli, F. Muscia, A. Martegani, M. Magoni, A. Costa, R. Gasparotti, M. Pavia, M. Sessa, F. Scomazzoni

Research output: Contribution to journalArticlepeer-review


Objective: To assess the feasibility, safety and preliminary efficacy of intra-arterial thrombolysis (IAT) compared with standard intravenous thrombolysis (IVT) for acute ischemic stroke. Methods: Eligible patients with ischemic stroke, who were devoid of contraindications, started IVT within 3 h or IAT as soon as possible within 6 h. Patients were randomized within 3 h of onset to receive either intravenous alteplase, in accordance with the current European labeling, or up to 0.9 mg/kg intra-arterial alteplase (maximum 90 mg), over 60 min into the thrombus, if necessary with mechanical clot disruption and/or retrieval. The purpose of the study was to determine the proportion of favorable outcome at 90 days. Safety endpoints included symptomatic intracranial hemorrhage (SICH), death and other serious adverse events. Results: 54 patients (25 IAT) were enrolled. Median time from stroke onset to start to treatment was 3 h 15 min for IAT and 2 h 35 min for IVT (p

Original languageEnglish
Pages (from-to)74-79
Number of pages6
JournalJournal of NeuroInterventional Surgery
Issue number1
Publication statusPublished - Mar 2010

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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