Introduction Successful reperfusion does not always yield sufficient clinical success in patients with acute ischemic stroke (AIS) admitted for mechanical thrombectomy (MT).

Aim of Study This is a single center, prospective, open-label, single-arm study study designed to determine the efficacy of Cerebrolysin treatment as an add-on therapy to MT in reducing global disability in subjects with AIS.

Methods Patients with a small established infarct core and with good collateral circulation who achieve significant reperfusion following MT and who receive additional Cerebrolysin within 8 h of stroke onset were compared to matched controls treated with MT alone, matched for age, clinical severity, occlusion location, baseline perfusion lesion volume, onset to reperfusion time, and use of iv thrombolytic therapy.

Results Patients receiving Cerebrolysin as an add-on therapy to MT and rehabilitation tended to have better short- and long-term prognosis. Cerebrolysin significantly decreased the risk of intracerebral secondary hemorrhages. Cerebrolysin treatment was an independent predictor of excellent outcome at 12M (p=0.04). The greatest benefit from cerebroprotection was found in patients receiving rtPA, with TICI 3, CTA-CS 3 or ASPECTS<10.

Conclusion There is a need for additional pharmacological treatment to minimize the risk of hemorrhagic transformation and to improve clinical outcomes after MT. Cerebroprotective activity of Cerebrolysin may enhance the beneficial effects of reperfusion therapy and rehabilitation. Strategy combining multimodal therapies with MT is feasible and could have additive, if not synergistic effects.

Disclosure of Interest no.