ArticleJournal of neurology2019
Endovascular stroke treatment's impact on malignant type of edema (ESTIMATE).
Article in Journal of neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- From therapeutic nihilism to armamentarium: A meta-analysis of randomized clinical trials assessing safety and efficacy of endovascular therapy for acute large ischemic strokes.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Pooled it
- Radiomics analysis for predicting malignant cerebral edema in patients undergoing endovascular treatment for acute ischemic strokeDiagnostic and interventional radiology (Ankara, Turkey) · 2023Trial
- Intracranial rescue stenting in the German stroke registry: a propensity score-matched multicenter study.Journal of neurology · 2026Article
- [Focus neurological intensive care medicine 2023/2024 : Summary of selected studies in intensive medical care].Die Anaesthesiologie · 2025Article
- No Harmful Effect of Endovascular Treatment before Decompressive Surgery-Implications for Handling Patients with Space-Occupying Brain Infarction.Journal of clinical medicine · 2024Article
- The risk and outcome of malignant brain edema in post-mechanical thrombectomy: acute ischemic stroke by anterior circulation occlusion.European journal of medical research · 2023Article
- [Focus neurological intensive care medicine 2021/2022 : Summary of selected intensive care studies].Die Anaesthesiologie · 2022Article
- Predictors and Dynamic Nomogram to Determine the Individual Risk of Malignant Brain Edema After Endovascular Thrombectomy in Acute Ischemic Stroke.Journal of clinical neurology (Seoul, Korea) · 2022Article
- A nomogram for predicting malignant cerebral artery infarction in the modern thrombectomy era.Frontiers in neurology · 2022Article
- [Focus on neurological intensive care medicine. Intensive care studies from 2020/2021].Der Anaesthesist · 2021Article
- Computed Tomography Based Score of Early Ischemic Changes Predicts Malignant Infarction.Frontiers in neurology · 2021Article
- Sonography of optic nerve sheath diameter identifies patients with middle cerebral artery infarction at risk of a malignant course: a pilot prospective observational study.Journal of neurology · 2020Observational
- [Neurological intensive care medicine : Intensive medical care studies from 2018-2019].Der Anaesthesist · 2020Article
Corrections and comments
- Erratum issued
Authors and funding
17 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeIn patients with acute ischemic stroke and large vessel occlusion, the prognosis has improved tremendously since the implementation of endovascular thrombectomy (EVT). The effect of EVT on the incidence of malignant middle cerebral artery infarctions (MMI) has not been studied before.
methodsESTIMATE, a multicenter retrospective study, evaluates data of ischemic stroke patients with occlusion in the anterior circulation in the years of 2007-2015 comparing three treatment options (no therapy; IV-TPA; IV-TPA plus EVT or EVT only). Primary endpoint of the study was the incidence of MMI on follow-up imaging and mortality rates. Secondary endpoints were functional outcome, further clinical and imaging data. Logistic and Cox-regression models with a propensity score weighting approach were applied to evaluate differences between treatment groups.
resultsIn 2161 patients over 9 years, EVT reduced the MMI rates significantly: patients without acute stroke treatment had increased odds for MMI of 1.57 [95% confidence interval (CI) 1.49-1.65]. In contrast, after treatment with IV-TPA, only we observed an OR of 0.88 (95% CI 0.83-0.94, p < 0.001), and after EVT an OR of 0.80 (95% CI 0.76-0.85, p < 0.001). This was more pronounced in larger pretreatment infarctions (ASPECTS < 5, p < 0.01). IV-TPA also lowers the MMI rates but not to the same extent. EVT-treated patients had increased survival rates (p < 0.05) and the best functional outcome at discharge.
conclusionsThe findings of this study illustrate that occurrence of MMI and mortality rates was significantly reduced in patients treated with EVT.
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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.