Evidence map›Paper›PMID 29986935›Full record

Trial reportStroke2018

Endovascular Treatment in the DEFUSE 3 Study.

Michael P Marks, Jeremy J Heit, Maarten G Lansberg, Stephanie Kemp, Soren Christensen, Colin P Derdeyn, Peter A Rasmussen, Osama O Zaidat, Joseph P Broderick, Sharon D Yeatts and 4 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02586415 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3), which is not on this map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing 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.

NCT02586415 naterminatednot on this map

Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3

TypeinterventionalSponsorGregory W AlbersRan2016 to 2017Enrolled182ConditionsStroke, Acute, Cerebral InfarctionArmsEndovascular Thrombectomy, Trevo Retriever, Solitaire™ FR Revascularization Device, Penumbra thrombectomy system, Covidien MindFrame Capture Revascularization Device
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Review
  9. Article
  10. Observational
  11. Article
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  14. Review
  15. Article
  16. Article
  17. Endovascular therapy for large vessel occlusion stroke: an update on the most recent clinical trials.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2019
    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

14 authors.

Michael P MarksFrom the Departments of Radiology and Neurology, Stanford Stroke Center, CA (M.P.M., J.J.H., M.G.L., S.K., S.C., S.H., M.M., G.W.A.).
Jeremy J HeitFrom the Departments of Radiology and Neurology, Stanford Stroke Center, CA (M.P.M., J.J.H., M.G.L., S.K., S.C., S.H., M.M., G.W.A.).
Maarten G LansbergFrom the Departments of Radiology and Neurology, Stanford Stroke Center, CA (M.P.M., J.J.H., M.G.L., S.K., S.C., S.H., M.M., G.W.A.).
Stephanie KempFrom the Departments of Radiology and Neurology, Stanford Stroke Center, CA (M.P.M., J.J.H., M.G.L., S.K., S.C., S.H., M.M., G.W.A.).
Soren ChristensenFrom the Departments of Radiology and Neurology, Stanford Stroke Center, CA (M.P.M., J.J.H., M.G.L., S.K., S.C., S.H., M.M., G.W.A.).
Colin P DerdeynDepartment of Radiology, University of Iowa (C.P.D.).
Peter A RasmussenDepartment of Neurological Surgery and the Cerebrovascular Center, Cleveland Clinic, OH (P.A.R.).
Osama O ZaidatDepartment of Neurosurgery, Mercy Health, Toledo, OH (O.O.Z.).
Joseph P BroderickDepartment of Neurology, University of Cincinnati, OH (J.P.B.).
Sharon D YeattsDepartment of Public Health Sciences, Medical University of South Carolina, Charleston (S.D.Y.).
Scott HamiltonFrom the Departments of Radiology and Neurology, Stanford Stroke Center, CA (M.P.M., J.J.H., M.G.L., S.K., S.C., S.H., M.M., G.W.A.).
Michael MlynashFrom the Departments of Radiology and Neurology, Stanford Stroke Center, CA (M.P.M., J.J.H., M.G.L., S.K., S.C., S.H., M.M., G.W.A.).
Gregory W AlbersFrom the Departments of Radiology and Neurology, Stanford Stroke Center, CA (M.P.M., J.J.H., M.G.L., S.K., S.C., S.H., M.M., G.W.A.).
DEFUSE 3 Investigators

Funding

NSTN National Clinical Coordinating CenterU01NS086872 · NINDS · UNIVERSITY OF CINCINNATI · PI Joseph Paul Broderick, Pooja Khatri · 2013 to 2026
$32.3M
DEFUSE 3: EnDovascular ThErapy Following Imaging EvalUation for ISchemic StrokE 3U01NS092076 · NINDS · STANFORD UNIVERSITY · PI ALBERS, GREGORY W · 2015 to 2016
$5.3M
Stanford University Regional Coordinating Stroke Center for the NIH Stroke Trials NetworkU24NS107220 · NINDS · STANFORD UNIVERSITY · PI MAARTEN G LANSBERG · 2018 to 2026
$2.8M
Stanford University Regional Coordinating Stroke Center for the NINDS Stroke TriaU10NS086487 · NINDS · STANFORD UNIVERSITY · PI ALBERS, GREGORY W · 2013 to 2017
$1.9M
NINDS NIH HHS U01 NS086872NINDS NIH HHS U01 NS092076NINDS NIH HHS U10 NS086487NINDS NIH HHS U24 NS107220
6 · The paper itself

Abstract

Background and Purpose- Endovascular therapy in an extended time window has been shown to be beneficial in selected patients. This study correlated angiographic outcomes of patients randomized to endovascular therapy with clinical and imaging outcomes in the DEFUSE 3 study (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3). Methods- Angiograms were assessed for the primary arterial occlusive lesion and the modified Thrombolysis in Cerebral Infarction (TICI) score at baseline and the final modified TICI score. Clinical outcomes were assessed using an ordinal analysis of 90-day modified Rankin Scale and a dichotomous analysis for functional independence (modified Rankin Scale score of 0-2). TICI scores were correlated with outcome, types of device used for thrombectomy, and 24-hour follow-up imaging. Results- TICI 2B-3 reperfusion was achieved in 70 of 92 patients (76%). TICI 2B-3 reperfusion showed a more favorable distribution of Rankin scores compared with TICI 0-2A; odds ratio, 2.77; 95% confidence interval, 1.17-6.56; P=0.019. Good functional outcome (90-day modified Rankin Scale score of 0-2) increased with better TICI scores ( P=0.0028). There was less disability comparing TICI 3 patients to TICI 2B patients ( P=0.037). Successful reperfusion (TICI 2B-3) was independent of the device used, the site of occlusion (internal carotid artery or M1) or adjunctive use of carotid angioplasty and stenting. Significantly less infarct growth at 24 hours was seen in TICI 3 patients compared with TICI 0-2A ( P=0.0015) and TICI 2B ( P=0.0002) patients. Conclusions- Thrombectomy in an extended time window demonstrates similar rates of TICI 2B-3 reperfusion to earlier time window studies. Successful reperfusion was independent of the device used, the site of occlusion or adjunctive use of carotid angioplasty and stenting. TICI 3 reperfusion was more likely to result in low rates of infarct growth at 24 hours and good functional outcome at 90 days. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT02586415.

Indexed as

Brain IschemiaCerebral InfarctionCerebrovascular DisordersEndovascular ProceduresFemaleHumansMaleProspective StudiesTreatment Outcomeangiographyangioplastycerebral infarctionreperfusionthrombectomy

Identifiers

PMID29986935
PMCPMC6202142

What OpenQuestion holds

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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.