Evidence map›Paper›PMID 30150448›Full record

ArticleIn vivo (Athens, Greece)

Mechanical Thrombectomy of Large Artery Occlusion Is Beneficial in Octogenarians.

Simo Karhi, Ossi Nerg, Tuuli Miettinen, Emmi Mäkipaakkanen, Mikko Taina, Hannu Manninen, Ritva Vanninen, Pekka Jäkälä

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in In vivo (Athens, Greece). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 pooled it
1.0field-weighted citation impact, top 23% 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.

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

5 citing papers in PubMed, 3 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. 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

8 authors at 2 institutions in 1 country.

Simo KarhiDepartment of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland simkar@student.uef.fi.
Ossi NergUnit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Tuuli MiettinenUnit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Emmi MäkipaakkanenUnit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Mikko TainaDepartment of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
Hannu ManninenDepartment of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
Ritva VanninenDepartment of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
Pekka JäkäläUnit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
University of Eastern Finland · FIKuopio University Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimRecent trials have established the benefit of endovascular treatment (EVT) for patients with acute ischemic stroke (AIS) due to large artery occlusion (LAO). However, older patients were often excluded from trials. EVT outcomes were retrospectively compared between octogenarians and younger patients treated for LAO in a tertiary hospital. PATIENTS AND

methodsA total of 199 consecutive patients with anterior circulation AIS that underwent EVT between 2009 and 2015 in the Kuopio University Hospital were included. Patients were dichotomized into younger (<80 years, N=162) and older (≥80 years, N=37) groups. Baseline, imaging, and procedural characteristics, the 3-month modified Rankin Scale (mRS), and 1-year mortality were assessed. To conduct a number-needed-to-treat (NNT) analysis, data on age-dichotomized control groups from a meta-analysis were acquired.

resultsCompared to younger patients, older patients exhibited atrial fibrillation (57% vs. 21%, p<0.01) and coronary artery disease (49% vs. 20%, p<0.01) more frequently and Internal Carotid Artery (ICA) occlusion less frequently (22% vs. 55%, p<0.01). Similar proportions of patients received preprocedural intravenous recombinant tissue-type plasminogen activator (r-tPA; 57% vs. 67%), general anesthesia (35% vs. 41%), and reperfusion (Thrombolysis in Cerebral Infarction scale 2b/3; 76% vs. 75%). Older patients had more complications during hospitalization (41% vs. 24%, p=0.034), higher 3-month mRS values (4.0±2.3 vs. 2.8±1.9, p<0.01), fewer favorable mRS values (mRS≤2: 27% vs. 52%, p<0.01), and higher 3-month (46% vs. 10% p<0.01) and 1-year mortality (49% vs. 11%, p<0.01). The NNT to achieve an additional patient with an independent outcome (mRS≤2) was 12 among older and six among younger patients.

conclusionDespite a poor recovery rate, octogenarians benefitted from EVT for AIS, with a NNT comparable to that of younger patients treated with intravenous r-tPA.

Indexed as

Mechanical ThrombolysisAgedAged, 80 and overAge FactorsCerebral ArteriesFemaleHumansMaleMiddle AgedRetrospective StudiesStrokeTreatment Outcomecerebral infarctionCerebrovascular strokeelderlyendovascular proceduresoctogenarianthrombectomy

Identifiers

PMID30150448
PMCPMC6199581
OpenAlexW2889327856

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.