Perceived Limits of Endovascular Treatment for Secondary Medium-Vessel-Occlusion Stroke

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F21%3A00074956" target="_blank" >RIV/00159816:_____/21:00074956 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/21:00124155

Result on the web

<a href="http://www.ajnr.org/lookup/doi/10.3174/ajnr.A7327" target="_blank" >http://www.ajnr.org/lookup/doi/10.3174/ajnr.A7327</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3174/ajnr.A7327" target="_blank" >10.3174/ajnr.A7327</a>

Result language

angličtina

Original language name

Perceived Limits of Endovascular Treatment for Secondary Medium-Vessel-Occlusion Stroke

Original language description

BACKGROUND AND PURPOSE: Thrombus embolization during mechanical thrombectomy occurs in up to 9% of cases, making secondary medium vessel occlusions of particular interest to neurointerventionalists. We sought to gain insight into the current endovascular treatment approaches for secondary medium vessel occlusion stroke in an international case-based survey because there are currently no clear recommendations for endovascular treatment in these patients. MATERIALS AND METHODS: Survey participants were presented with 3 cases involving secondary medium vessel occlusions, each consisting of 3 case vignettes with changes in the patient?s neurologic status (improvement, no change, unable to assess). Multivariable logistic regression analyses clustered by the respondent?s identity were used to assess factors influencing the decision to treat. RESULTS: In total, 366 physicians (56 women, 308 men, 2 undisclosed) from 44 countries provided 3294 responses to 9 scenarios. Most (54.1%, 1782/3294) were in favor of endovascular treatment. Participants were more likely to treat occlusions in the anterior M2/3 (74.3%; risk ratio = 2.62; 95% CI, 2.27?3.03) or A3 (59.7%; risk ratio = 2.11; 95% CI, 1.83?2.42) segment compared with the M3/4 segment (28.3%; reference). Physicians were less likely to pursue endovascular treatment in patients who showed neurologic improvement than in patients with an unchanged neurologic deficit (49.9% versus 57.0% responses in favor of endovascular treatment, respectively; risk ratio = 0.88, 95% CI, 0.83?0.92). Interventionalists and more experienced physicians were more likely to treat secondary medium vessel occlusions. CONCLUSIONS: Physicians? willingness to treat secondary medium vessel occlusions endovascularly is limited and varies per occlusion location and change in neurologic status. More evidence on the safety and efficacy of endovascular treatment for secondary medium vessel occlusion stroke is needed.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30200 - Clinical medicine

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2021

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

American Journal of Neuroradiology

ISSN

0195-6108

e-ISSN

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Volume of the periodical

42

Issue of the periodical within the volume

12

Country of publishing house

US - UNITED STATES

Number of pages

6

Pages from-to

2188-2193

UT code for WoS article

000711963300001

EID of the result in the Scopus database

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