Evidence map›Paper›PMID 27940648›Full record

Trial reportNeurology2017

Endovascular treatment improves cognition after stroke: A secondary analysis of REVASCAT trial.

Elena López-Cancio, Tudor G Jovin, Erik Cobo, Neus Cerdá, Marta Jiménez, Meritxell Gomis, María Hernández-Pérez, Cynthia Cáceres, Pere Cardona, Blanca Lara and 5 more

2 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01692379 phase3terminatednot on this map

RandomizEd Trial of reVascularizAtion With Solitaire FR® Device Versus Best mediCal Therapy in the Treatment of Acute Stroke Due to anTerior Circulation Large Vessel Occlusion Presenting Within 8 Hours of Symptom Onset

TypeinterventionalSponsorFundacio Ictus Malaltia VascularRan2012 to 2015Enrolled206ConditionsAcute StrokeArmsSolitaire FR device, Medical treatment
NCT04099615 completednot on this mapstarted 2018, after this paper: background citation

New Predictive Biomarkers of Functional Recovery Prior the Endovascular Treatment of Acute Ischemic Stroke. PROMISE (Somatosensory Evoked POtEntials MonItoring During Acute Ischemic StrokE) Study

Typeobservational_patient_registrySponsorFundació Institut Germans Trias i PujolRan2018 to 2020Enrolled228ConditionsAcute Cerebrovascular Accident, Endovascular ProceduresArmsSomatosensory Evoked Potentials
3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 47 citations in OpenAlex.

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  8. Association between pre-stroke frailty status and post-stroke cognitive impairment in patients with acute large artery atherosclerotic cerebral infarction.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2025
    Article
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  10. Vascular cognitive impairment and dementia: Mechanisms, treatment, and future directions.International journal of stroke : official journal of the International Stroke Society · 2024
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Elena López-CancioFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain. elenacancio@gmail.com.
Tudor G JovinFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Erik CoboFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Neus CerdáFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Marta JiménezFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Meritxell GomisFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
María Hernández-PérezFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Cynthia CáceresFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Pere CardonaFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Blanca LaraFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Arturo RenúFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Laura LlullFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Sandra BonedFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Marian MuchadaFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Antoni DávalosFrom the Department of Neuroscience (E.L.-C., M.J., M.G., M.H.-P., C.C., A.D.), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Stroke Institute (T.G.J.), Department of Neurology, UPMC, Pittsburgh, PA; Statistics and Operations Research (E.C.), Barcelona-Tech; Bioclever (N.C.), Department of Statistics; Hospital de Bellvitge (P.C., B.L.), L'Hospitalet de Llobregat; Hospital Clínic i Provincial (A.R., L.L.); and Hospital Vall d'Hebron (S.B., M.M.), Barcelona, Spain.
Bellvitge University Hospital · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the effect of endovascular treatment on cognitive function as a prespecified secondary analysis of the REVASCAT (Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours) trial.

methodsREVASCAT randomized 206 patients with anterior circulation proximal arterial occlusion stroke to Solitaire thrombectomy or best medical treatment alone. Patients with established dementia were excluded from enrollment. Cognitive function was assessed in person with Trail Making Test (TMT) Parts A and B at 3 months and 1 year after randomization by an investigator masked to treatment allocation. Test completion within 5 minutes, time of completion (seconds), and number of errors were recorded.

resultsFrom November 2012 to December 2014, 206 patients were enrolled in REVASCAT. TMT was assessed in 82 of 84 patients undergoing thrombectomy and 86 of 87 control patients alive at 3 months and in 71 of 79 patients undergoing thrombectomy and 72 of 78 control patients alive at 1 year. Rates of timely TMT-A completion were similar in both treatment arms, although patients undergoing thrombectomy required less time for TMT-A completion and had higher rates of error-free TMT-A performance. Thrombectomy was also associated with a higher probability of timely TMT-B completion (adjusted odds ratio 3.17, 95% confidence interval 1.51-6.66 at 3 months; and adjusted ratio 3.66, 95% confidence interval 1.60-8.35 at 1 year) and shorter time for TMT-B completion. Differences in TMT completion times between treatment arms were significant in patients with good functional outcome but not in those who were functionally dependent (modified Rankin Scale score >2). Poorer cognitive outcomes were significantly associated with larger infarct volume, higher modified Rankin Scale scores, and worse quality of life.

conclusionsThrombectomy improves TMT performance after stroke, especially among patients who reach good functional recovery. CLINICALTRIALSGOV IDENTIFIER: NCT01692379. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with stroke from acute anterior circulation proximal arterial occlusion, thrombectomy improves performance on the TMT at 3 months.

Indexed as

Brain InfarctionCognition DisordersEndovascular ProceduresExecutive FunctionFemaleFollow-Up StudiesHumansMaleNeuropsychological TestsSpainStrokeThrombectomy

Identifiers

PMID27940648
PMCPMC5272792
OpenAlexW2560746571

What OpenQuestion holds

Textmetadata
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.