Researchers analyzed data from 627 stroke patients who had a large blood clot blocking a major brain artery. All patients were eligible for a clot-busting drug called alteplase and underwent a mechanical clot removal procedure called endovascular thrombectomy (EVT). The study compared two treatment strategies: 'bridging therapy' (receiving the drug alteplase before the procedure) and 'direct EVT' (going straight to the procedure without the drug).
The main goal was to see if high blood sugar levels at the hospital were linked to different bleeding risks between these two treatment approaches. The analysis found that for most patients, the bleeding risks were similar. However, in a smaller group of 71 patients with very high blood sugar (over 11.1 mmol/L), those who received bridging therapy had a higher chance of developing a serious type of brain bleed called a parenchymal hematoma, compared to those who had direct EVT.
No specific safety concerns beyond this bleeding risk were reported in this analysis. It is important to be careful because this was a 'post hoc' or exploratory look at existing data, not a study designed from the start to answer this specific question. The findings only apply to stroke patients who are candidates for the clot removal procedure. Readers should understand that this research suggests doctors might need to consider a patient's blood sugar level when choosing a treatment plan, but more studies are needed to confirm this link.