Thrombectomy vs medical management in low NIHSS acute anterior circulation stroke
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F44555601%3A13450%2F20%3A43898534" target="_blank" >RIV/44555601:13450/20:43898534 - isvavai.cz</a>
Alternative codes found
RIV/00216224:14110/20:00118138 RIV/00216208:11110/20:10415902 RIV/00216208:11130/20:10415902 RIV/00216208:11140/20:10415902 and 8 more
Result on the web
<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836655/" target="_blank" >https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836655/</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1212/WNL.0000000000010955" target="_blank" >10.1212/WNL.0000000000010955</a>
Alternative languages
Result language
angličtina
Original language name
Thrombectomy vs medical management in low NIHSS acute anterior circulation stroke
Original language description
ObjectiveTo undertake an effectiveness and safety analysis of EVT in patients with LVO and NIH Stroke Scale (NIHSS) score <= 6 using datasets of multicenter and multinational nature.MethodsWe pooled patients with anterior circulation occlusion from 3 prospective international cohorts. Patients were eligible if presentation occurred within 12 hours from last known well and baseline NIHSS <= 6. Primary outcome was modified Rankin Scale (mRS) score 0-1 at 90 days. Secondary outcomes included neurologic deterioration at 24 hours (change in NIHSS of >= 2 points), mRS 0-2 at 90 days, and 90-day all-cause mortality. We used propensity score matching to adjust for nonrandomized treatment allocation.ResultsAmong 236 patients who fit inclusion criteria, 139 received EVT and 97 received medical management. Compared tomedical management, the EVT group was younger (65 vs 72 years; p < 0.001), had more proximal occlusions (p < 0.001), and less frequently received concurrent IV thrombolysis (57.7% vs 71.2%; p = 0.04). After propensity score matching, clinical outcomes between the 2 groups were not significantly different. EVT patients had an 8.6% (95% confidence interval [CI] -8.8% to 26.1%) higher rate of excellent 90-day outcome, despite a 22.3% (95% CI, 3.0%-41.6%) higher risk of neurologic deterioration at 24 hours.ConclusionsEVT for LVO in patients with low NIHSS score was associated with increased risk of neurologic deterioration at 24 hours. However, both EVT and medical management resulted in similar proportions of excellent clinical outcomes at 90 days.Classification of evidenceThis study providesClass III evidence that for patients with acute anterior circulation ischemic strokes and LVO with NIHSS < 6, EVT and medical management result in similar outcomes at 90 days.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30210 - Clinical neurology
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2020
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Neurology
ISSN
0028-3878
e-ISSN
1526-632X
Volume of the periodical
95
Issue of the periodical within the volume
24
Country of publishing house
US - UNITED STATES
Number of pages
9
Pages from-to
3364-3372
UT code for WoS article
000607315800032
EID of the result in the Scopus database
2-s2.0-85098531606