Objective Data regarding the efficacy and safety of bridging thrombolysis (BT) initiated before transfer for evaluation of endovascular therapy is heterogeneous. We, therefore, analyse efficacy and safety of BT in patients treated within a drip-and-ship stroke service. Methods Consecutive adult patients suffering from acute ischaemic stroke and large-vessel occlusions (LVO) transferred to our comprehensive stroke centre for evaluation of endovascular therapy in 2017–2020 were identified from a local prospective stroke database and categorised according to BT and no-BT. BT was defined as intravenous thrombolysis initiated before transfer. LVO was assessed before and after transfer. Functional outcome before stroke and at 3 months using the modified Rankin scale (mRS) was determined. Excellent outcome was defined as mRS 0–1 or return to prestroke mRS. For safety analysis, intracranial haemorrhages and mortality at 3 months were analysed. Main analysis was limited to patients with anterior circulation stroke. Results Of N=714 patients, n=394 (55.2%) received BT. More patients in the BT group with documented LVO before transfer recanalised without endovascular therapy (n=46, 11.7%) than patients who did not receive BT before transfer (n=4, 1.3%, p<0.001). In multivariate analysis, BT was the strongest independent predictor of early recanalisation (adjusted OR 10.9, 95% CI 3.8 to 31.1, p<0.001). BT tended to be an independent predictor of an excellent outcome at 3 months (adjusted OR 1.38, 95% CI 0.97 to 1.96, p=0.077). There were no differences in safety between the BT and no-BT groups. Conclusions BT initiated before transfer was a strong independent predictor of early recanalisation. Data are available upon reasonable request from the corresponding author.

中文翻译：

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在点滴式中风服务中转移前开始桥接溶栓的有效性和安全性

目的 关于在转移前开始桥接溶栓 (BT) 以评估血管内治疗的有效性和安全性的数据是异质的。因此，我们分析了 BT 在接受滴注和运送中风服务的患者中的疗效和安全性。方法从当地前瞻性卒中数据库中筛选出2017-2020年连续​​转入我院综合卒中中心评估血管内治疗的急性缺血性卒中和大血管闭塞（LVO）成年患者，并根据BT和无BT进行分类。BT被定义为在转移前开始静脉溶栓。LVO 在转移前后进行了评估。使用改良的 Rankin 量表 (mRS) 确定中风前和 3 个月时的功能结果。优秀结果定义为 mRS 0-1 或恢复到卒中前 mRS。对于安全性分析，分析了 3 个月时的颅内出血和死亡率。主要分析仅限于前循环卒中患者。结果 N=714 患者中，n=394 (55.2%) 接受了 BT。与转移前未接受 BT 的患者（n=4, 1.3%, p<0.001）相比，BT 组中有更多患者在转移前有记录的 LVO 在没有血管内治疗的情况下再通（n=46, 11.7%）。在多变量分析中，BT 是早期再通的最强独立预测因子（调整后的 OR 10.9，95% CI 3.8 至 31.1，p<0.001）。BT 往往是 3 个月时良好结果的独立预测因子（调整后的 OR 1.38，95% CI 0.97 至 1.96，p=0.077）。BT 组和非 BT 组之间的安全性没有差异。结论 移植前开始的 BT 是早期再通的一个强有力的独立预测因子。数据可根据通讯作者的合理要求提供。