Evidence map›Paper›PMID 30944585›Full record

ArticleTherapeutic advances in neurological disorders2019

Outcome, efficacy and safety of endovascular thrombectomy in ischaemic stroke according to time to reperfusion: data from a multicentre registry.

Thomas Raphael Meinel, Johannes Kaesmacher, Pasquale Mordasini, Pascal J Mosimann, Simon Jung, Marcel Arnold, Mirjam Rachel Heldner, Patrik Michel, Steven D Hajdu, Marc Ribo and 11 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Therapeutic advances in neurological disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03496064 (Bernese-European RegistrY for Ischemic Stroke Patients Treated Outside Current Guidelines With Neurothrombectomy Devices Using the SOLITAIRE™ FR With the Intention For Thrombectomy), which is not on this map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 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.

NCT03496064 completednot on this map

Bernese-European RegistrY for Ischemic Stroke Patients Treated Outside Current Guidelines With Neurothrombectomy Devices Using the SOLITAIRE™ FR With the Intention For Thrombectomy

TypeobservationalSponsorInsel Gruppe AG, University Hospital BernRan2017 to 2018Enrolled2,000ConditionsIschemic StrokeArmsSuccessful reperfusion
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
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  6. 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

21 authors.

Thomas Raphael MeinelDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-0647-9273
Johannes KaesmacherInstitute of Diagnostic and Interventional Neuroradiology, Institute of Diagnostic, Interventional and Pediatric Radiology and Department of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Pasquale MordasiniUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Pascal J MosimannUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Simon JungDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Marcel ArnoldDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Mirjam Rachel HeldnerDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Patrik MichelDepartment of Neurology, CHUV Lausanne, Lausanne, Switzerland.
Steven D HajduDepartment of Radiology, CHUV Lausanne, Lausanne, Switzerland.
Marc RiboDepartment of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain.
Manuel RequenaDepartment of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain.
Christian MaegerleinDepartment of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
Benjamin FriedrichDepartment of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
Vincent CostalatDepartment of Neuroradiology, CHU Montpellier, Montpellier, France.
Amel BenaliDepartment of Neuroradiology, CHU Montpellier, Montpellier, France.
Laurent PierotDepartment of Neurology, Toronto Western Hospital, Toronto, Canada.
Matthias GawlitzaDepartment of Neuroradiology, CHU Reims, Reims, France.
Joanna SchaafsmaDepartment of Neurology, Toronto Western Hospital, Toronto, Canada.
Vitor Mendes PereiraJoint Department of Medical Imaging, Toronto Western Hospital, Toronto, Canada.
Jan GrallaUniversity Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
Urs FischerDepartment of Neurology, University Hospital Bern, Inselspital, University of Bern, Freiburgstrasse 8, CH-3010, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeIn acute ischaemic stroke (AIS) of the anterior circulation (AC) treated with mechanical thrombectomy (MT), data point to a decline of treatment effect with increasing time from symptom onset to treatment. However, the magnitude of the decline will depend on the clinical setting and imaging selection used. The aims of this study were (1) to evaluate the clinical effect of time to reperfusion (TTR); and (2) to assess the safety and technical efficacy of MT according to strata of TTR.

methodsUsing the retrospective multicentre BEYOND-SWIFT registry data (ClinicalTrials.gov identifier: NCT03496064), we compared safety and efficacy of MT in 1461 patients between TTR strata of 0-180 min (

resultsEvery hour delay in TTR was a significant factor related to mRS 0-2 (aOR 0.933, 95% CI 0.887-0.981) with an estimated 1.5% decreased probability of good functional outcome per hour delay of reperfusion, and mRS 0-1 (aOR 0.929, 95% CI 0.877-0.985). Patients with late TTR had lower rates of successful and excellent reperfusion, higher complication rates and number of passes.

conclusionsTTR is an independent factor related to long-term functional outcome. With increasing TTR, interventional procedures become technically less effective. Efforts should be made to shorten TTR through optimized prehospital and in-hospital pathways.

Indexed as

endovascularmechanical thrombectomystrokesymptom onsetthrombolysistime to reperfusiontime to treatment

Identifiers

PMID30944585
PMCPMC6437320

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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.