Stroke patients treated by thrombectomy in real life differ from cohorts of the clinical trials: a prospective observational study

BMC Neurology
Milani Deb-ChatterjiGötz Thomalla

Abstract

Randomized controlled trials (RCTs) demonstrated efficacy and safety of endovascular treatment (ET) in anterior circulation large vessel occlusions (LVO). We aimed at investigating how stroke patients treated by thrombectomy in clinical practice and their outcome compare to cohorts and results of thrombectomy trials. In a prospective study, we consecutively included stroke patients treated by thrombectomy (2015-2017). Baseline characteristics, procedural and outcome data were analyzed. Outcome was assessed by modified Rankin Scale (mRS) at 90 days. Ordinal regression analysis was performed to identify predictors of outcome. Thrombectomy was applied in 264 patients (median 75 years, 49.6% female). Median baseline National Institutes of Health Stroke Scale (NIHSS) was 16, 58.0% received concomitant intravenous thrombolysis, 62.1% were referred from external hospitals. Median Alberta Stroke Program Early CT Score (ASPECTS) was 7. Successful recanalization (modified Thrombolysis in Cerebral Infarction Score, mTICI 2b/3) was achieved in 72.0%. Symptomatic intracranial hemorrhage (sICH) occurred in 4.5%. Independent outcome (mRS 0-2) was achieved in 26.2%, poor outcome (mRS 5-6) in 49.2%. Only 33.5% met the stringent enrolment criter...Continue Reading

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Citations

Sep 17, 2020·Journal of Neurology, Neurosurgery, and Psychiatry·Peter B Sporns
May 28, 2021·Journal of Neurointerventional Surgery·Devin V BageacReade De Leacy
Jun 21, 2021·The Journal of Emergency Medicine·Amelia Adcock
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Aug 23, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Masahiro KatsumataTeruyuki Hirano
Sep 21, 2021·Stroke; a Journal of Cerebral Circulation·Gabriel BroocksUta Hanning
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