Evidence map›Paper›PMID 31412753›Full record

SynthesisStroke2019

Does Sex Modify the Effect of Endovascular Treatment for Ischemic Stroke?

Vicky Chalos, Inger R de Ridder, Hester F Lingsma, Scott Brown, Robert J van Oostenbrugge, Mayank Goyal, Bruce C V Campbell, Keith W Muir, Francis Guillemin, Serge Bracard and 10 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Stroke, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing 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

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

  1. Pooled it
  2. Observational
  3. Genetic determinants of insufficiency of the collateral circulation.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026
    Review
  4. Sex and gender-related differences in neurological diseases: current challenges and recommendations for clinical practice.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors.

Vicky ChalosFrom the Department of Neurology, Erasmus MC University Medical Center the Netherlands (V.C., D.W.J.D.).
Inger R de RidderDepartment of Neurology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, the Netherlands (I.R.d.R., R.J.v.O.).
Hester F LingsmaDepartment of Public Health, Erasmus MC University Medical Center the Netherlands (V.C., H.F.L.).
Scott BrownAltair Biostatistics, St. Louis Park, MN (S.B.).
Robert J van OostenbruggeDepartment of Neurology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, the Netherlands (I.R.d.R., R.J.v.O.).
Mayank GoyalDepartments of Clinical Neuroscience and Radiology, Hotchkiss Brain Institute, Cummings School of Medicine, University of Calgary, Canada (M.G., M.D.H., A.M.D.).
Bruce C V CampbellDepartment of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Australia (B.C.V.C.).
Keith W MuirInstitute of Neuroscience and Psychology, University of Glasgow, Queen Elizabeth University Hospital, United Kingdom (K.W.M.).
Francis GuilleminDepartment of Clinical Epidemiology, Inserm, University of Lorraine and University Hospital of Nancy, France (F.G.).
Serge BracardAltair Biostatistics, St. Louis Park, MN (S.B.).
Philip WhiteInstitute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
Antoni DávalosDepartment of Neuroscience, Hospital Germans Trias y Pujol, Barcelona, Spain (A.D.).
Tudor G JovinDepartment of Neurology, Stroke Institute, University of Pittsburgh Medical Center Stroke Institute, Presbyterian University Hospital, PA (T.G.J.).
Michael D HillDepartments of Clinical Neuroscience and Radiology, Hotchkiss Brain Institute, Cummings School of Medicine, University of Calgary, Canada (M.G., M.D.H., A.M.D.).
Peter J MitchellDepartment of Radiology, Royal Melbourne Hospital, University of Melbourne, Australia (P.J.M.).
Andrew M DemchukDepartments of Clinical Neuroscience and Radiology, Hotchkiss Brain Institute, Cummings School of Medicine, University of Calgary, Canada (M.G., M.D.H., A.M.D.).
Jeffrey L SaverDepartment of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of Los Angeles, CA (J.L.S.).
Wim H van ZwamDepartment of Radiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, the Netherlands (W.H.v.Z.).
Diederik W J DippelFrom the Department of Neurology, Erasmus MC University Medical Center the Netherlands (V.C., D.W.J.D.).
HERMES Collaborators

Funding

Department of Health HTA/14/08/47
6 · The paper itself

Abstract

Background and Purpose- Previous studies have reported less favorable outcome and less effect of endovascular treatment (EVT) after ischemic stroke in women than in men. Our aim was to study the influence of sex on outcome and on the effect of EVT for ischemic stroke in recent randomized trials on EVT. Methods- We used data from 7 randomized controlled trials on EVT within the HERMES collaboration. The primary outcome was 90-day functional outcome (modified Rankin Scale). We compared baseline characteristics and outcomes between men and women. With ordinal logistic regression, we evaluated the association between EVT and 90-day functional outcome for men and women separately, adjusted for potential confounders. We tested for interaction between sex and EVT. Results- We included 1762 patients in the analyses, of whom 833 (47%) were women. Women were older (median, 70 versus 66 years; P<0.001), were smoking less often (30% versus 44%; P<0.001), and had higher collateral grades (grade 3: 46% versus 35%; P<0.001) than men. Functional independence (modified Rankin Scale score, 0-2) at 90 days was reached by 318 women (39%) and 364 men (39%). The effect of EVT on the ordinal modified Rankin Scale was similar in women (adjusted common odds ratio [acOR], 2.13; 95% CI, 1.47-3.07) and men (acOR, 2.16; 95% CI, 1.59-2.96), with a P for interaction of 0.926. Conclusions- Sex does not influence clinical outcome after EVT and does not modify treatment effect of EVT. Therefore, sex should not be a consideration in the selection of patients for EVT.

Indexed as

Sex CharacteristicsAgedBrain IschemiaEndovascular ProceduresFemaleHumansMaleMiddle AgedRandomized Controlled Trials as TopicStrokeTreatment Outcomerandomized controlled trialsexstrokethrombectomy

Identifiers

PMID31412753
PMCPMC6727933

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.