Evidence map›Paper›PMID 29191873›Full record

Trial reportAJNR. American journal of neuroradiology2018

Time for a Time Window Extension: Insights from Late Presenters in the ESCAPE Trial.

J W Evans, B R Graham, P Pordeli, F S Al-Ajlan, R Willinsky, W J Montanera, J L Rempel, A Shuaib, P Brennan, D Williams and 19 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in AJNR. American journal of neuroradiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Review
  8. Observational
  9. Article
  10. Article
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

29 authors.

J W EvansFrom the Departments of Clinical Neurosciences and Radiology (J.W.E., B.R.G., F.S.A.-A., P.A.B., A.M.D., M.G., M.D.H., B.K.M.).ORCID 0000-0002-6414-528X
B R GrahamFrom the Departments of Clinical Neurosciences and Radiology (J.W.E., B.R.G., F.S.A.-A., P.A.B., A.M.D., M.G., M.D.H., B.K.M.).ORCID 0000-0003-0490-3816
P PordeliCommunity Health Sciences and Department of Medicine (P.P., M.D.H., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID 0000-0002-4318-583X
F S Al-AjlanFrom the Departments of Clinical Neurosciences and Radiology (J.W.E., B.R.G., F.S.A.-A., P.A.B., A.M.D., M.G., M.D.H., B.K.M.).ORCID 0000-0002-0501-479X
R WillinskyDepartment of Medical Imaging (R.W., W.J.M.).ORCID 0000-0002-5898-7990
W J MontaneraDepartment of Medical Imaging (R.W., W.J.M.).ORCID 0000-0001-8282-1256
J L RempelDepartments of Radiology (J.L.R.).ORCID 0000-0003-2324-8415
A ShuaibMedicine (Neurology) (A.S.), University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0002-3380-7068
P BrennanDepartments of Neuroradiology (P.B.).ORCID 0000-0002-7977-6818
D WilliamsGeriatric and Stroke Medicine (D.W.), Beaumont Hospital and the Royal College of Surgeons in Ireland, Dublin, Ireland.ORCID 0000-0002-1923-462X
D RoyDepartments of Radiology (D.R.).ORCID 0000-0002-6066-4453
A Y PoppeNeurosciences (A.Y.P.), Centre hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada.ORCID 0000-0002-1419-2635
T G JovinDepartment of Neurology (T.G.J.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.ORCID 0000-0002-2619-6975
T DevlinErlanger Medical Centre (T.D.).ORCID 0000-0002-0202-6728
B W BaxterDepartment of Radiology (B.W.B), Erlanger Hospital, University of Tennessee, Chattanooga, Tennessee.ORCID 0000-0002-3403-428X
T KringsDivision of Radiology (T.K.).ORCID 0000-0001-6321-5787
F L SilverDivision of Neurology (F.L.S., C.F.), Department of Medicine, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.ORCID 0000-0002-7569-8429
D F FreiColorado Neurological Institute (D.F.F., D.T.), Engelwood, Colorado.ORCID 0000-0003-2630-0848
C FanaleDivision of Neurology (F.L.S., C.F.), Department of Medicine, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.ORCID 0000-0003-1247-7618
D TampieriColorado Neurological Institute (D.F.F., D.T.), Engelwood, Colorado.ORCID 0000-0002-0329-3262
J TeitelbaumMontreal Neurological Institute (J.T.), McGill University, Montreal, Quebec, Canada.ORCID 0000-0002-9834-3882
D IancuDepartment of Radiology (D.I.), The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.ORCID 0000-0003-2041-9178
J ShankarDepartment of Neuroradiology (J.S.), Dalhousie University, Halifax, Nova Scotia, Canada.ORCID 0000-0002-3707-9723
P A BarberFrom the Departments of Clinical Neurosciences and Radiology (J.W.E., B.R.G., F.S.A.-A., P.A.B., A.M.D., M.G., M.D.H., B.K.M.).ORCID 0000-0002-6051-1078
A M DemchukFrom the Departments of Clinical Neurosciences and Radiology (J.W.E., B.R.G., F.S.A.-A., P.A.B., A.M.D., M.G., M.D.H., B.K.M.).ORCID 0000-0002-4930-7789
M GoyalFrom the Departments of Clinical Neurosciences and Radiology (J.W.E., B.R.G., F.S.A.-A., P.A.B., A.M.D., M.G., M.D.H., B.K.M.).ORCID 0000-0001-9060-2109
M D HillFrom the Departments of Clinical Neurosciences and Radiology (J.W.E., B.R.G., F.S.A.-A., P.A.B., A.M.D., M.G., M.D.H., B.K.M.).ORCID 0000-0002-6269-1543
B K MenonFrom the Departments of Clinical Neurosciences and Radiology (J.W.E., B.R.G., F.S.A.-A., P.A.B., A.M.D., M.G., M.D.H., B.K.M.) docbijoymenon@gmail.com.ORCID 0000-0002-3466-496X
ESCAPE Trial Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeThe safety and efficacy of endovascular therapy for large-artery stroke in the extended time window is not yet well-established. We performed a subgroup analysis on subjects enrolled within an extended time window in the Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial. MATERIALS AND

methodsFifty-nine of 315 subjects (33 in the intervention group and 26 in the control group) were randomized in the ESCAPE trial between 5.5 and 12 hours after last seen healthy (likely to have groin puncture administered 6 hours after that). Treatment effect sizes for all relevant outcomes (90-day mRS shift, mRS 0-2, mRS 0-1, and 24-hour NIHSS scores and intracerebral hemorrhage) were reported using unadjusted and adjusted analyses.

resultsThere was no evidence of treatment heterogeneity between subjects in the early and late windows. Treatment effect favoring intervention was seen across all clinical outcomes in the extended time window (absolute risk difference of 19.3% for mRS 0-2 at 90 days). There were more asymptomatic intracerebral hemorrhage events within the intervention arm (48.5% versus 11.5%,

conclusionsPatients with an extended time window could potentially benefit from endovascular treatment. Ongoing randomized controlled trials using imaging to identify late presenters with favorable brain physiology will help cement the paradigm of using time windows to select the population for acute imaging and imaging to select individual patients for therapy.

Indexed as

AgedBrain IschemiaComputed Tomography AngiographyEndovascular ProceduresFemaleHumansMaleMiddle AgedTime FactorsTomography, X-Ray ComputedTreatment Outcome

Identifiers

PMID29191873
PMCPMC7410688

What OpenQuestion holds

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Registered trials

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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.