ArticleFrontiers in neurology2026
Efficacy of rt-PA versus Urokinase in early time windows for minimally invasive intracerebral hemorrhage evacuation and exploratory TAFI pharmacogenomics.
Article in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Minimally invasive hematoma evacuation with local thrombolysis is increasingly used for spontaneous intracerebral hemorrhage (ICH), yet comparative data on thrombolytic agents across early time windows remain limited. Whether the thrombin-activatable fibrinolysis inhibitor (TAFI) Thr325Ile polymorphism modulates thrombolytic efficacy in this setting is unknown. Methods: We conducted a retrospective comparative cohort study involving 120 patients with supratentorial ICH. Following minimally invasive hematoma aspiration, patients were treated with either rt-PA ( Results: rt-PA was associated with better neurological and functional outcomes than urokinase from discharge onward across all three time windows (all Bonferroni-adjusted Conclusion: rt-PA was associated with more favorable outcomes than urokinase for minimally invasive ICH evacuation in this retrospective cohort, with the ultra-acute window conferring the greatest benefit. The TAFI Ile325 genotype may represent a candidate pharmacogenomic marker for enhanced rt-PA response during this early period. These hypothesis-generating findings require validation in prospective, multicenter studies.
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