Introduction: Problem of the premature standard of care
Does it make sense to intentionally treat a patient with thrombolysis and endovascular intervention?
Systemic thrombolysis followed by mechanical thrombectomy could worsen bleeding complications.
A remaining question is what the optimal anticoagulant strategy is for patients undergoing mechanical thrombectomy. Systemic thrombolysis may not be the best choice for this situation, because it could increase the risk of peri-procedural hemorrhage and it is difficult to reverse in the event of an intracranial hemorrhage. Heparin infusions have previously been investigated as a bridge to thrombectomy and may deserve re-evaluation in combination with current interventional technology. Compared to percutaneous coronary intervention, very little is known about this topic and critical questions remain to be answered.