Thrombectomy vs medical management in low NIHSS acute anterior circulation stroke

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61988987%3A17110%2F20%3AA2302FOW" target="_blank" >RIV/61988987:17110/20:A2302FOW - 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 7 more

Result on the web

<a href="https://www.webofscience.com/wos/woscc/full-record/WOS:000607315800032" target="_blank" >https://www.webofscience.com/wos/woscc/full-record/WOS:000607315800032</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1212/WNL.0000000000010955" target="_blank" >10.1212/WNL.0000000000010955</a>

Result language

angličtina

Original language name

Thrombectomy vs medical management in low NIHSS acute anterior circulation stroke

Original language description

Objective To 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. Methods We 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. Results Among 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. Conclusions EVT 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 evidence This 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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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

30103 - Neurosciences (including psychophysiology)

Project

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Continuities

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Publication year

2020

Confidentiality

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

Name of the periodical

Neurology

ISSN

0028-3878

e-ISSN

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Volume of the periodical

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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

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