Evidence map›Paper›PMID 31511891›Full record

Trial reportNeurosurgery2020

Recurrent Hemispheric Stroke Syndromes in Symptomatic Atherosclerotic Internal Carotid Artery Occlusions: The Carotid Occlusion Surgery Study Randomized Trial.

Fadi Nahab, Michael Liu, Haseeb A Rahman, Srikant Rangaraju, Daniel Barrow, C Michael Cawley, Robert L Grubb, Colin P Derdeyn, Harold P Adams, Tom O Videen and 2 more

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.1field-weighted citation impact, top 12% 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

7 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
  2. Association of cognitive function and hypoperfusion in Moyamoya disease patients without stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2023
    Article
  3. Article
  4. Article
  5. Observational
  6. Article
  7. 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

12 authors at 3 institutions in 1 country.

Fadi NahabEmory University, Atlanta, Georgia.
Michael LiuEmory University, Atlanta, Georgia.
Haseeb A RahmanEmory University, Atlanta, Georgia.
Srikant RangarajuEmory University, Atlanta, Georgia.
Daniel BarrowEmory University, Atlanta, Georgia.
C Michael CawleyEmory University, Atlanta, Georgia.
Robert L GrubbCharleston, South Carolina.
Colin P DerdeynUniversity of Iowa, Iowa City, Iowa.
Harold P AdamsUniversity of Iowa, Iowa City, Iowa.
Tom O VideenSanta Fe, New Mexico.
M Bridget ZimmermanUniversity of Iowa, Iowa City, Iowa.
William J PowersUniversity of North Carolina, Chapel Hill, North Carolina.
Emory University · USUniversity of Iowa · USUniversity of North Carolina at Chapel Hill · US

Funding

DMC-Carotid Occlusion Surgery Study (COSS)U01NS041895 · NINDS · UNIVERSITY OF IOWA · PI CLARKE, WILLIAM R. · 2001 to 2011
$7.5M
NINDS NIH HHS U01 NS041895
6 · The paper itself

Abstract

backgroundThere are limited data on outcomes of extracranial-intracranial (EC-IC) bypass in patients with recurrent hemispheric syndromes due to atherosclerotic internal carotid artery occlusion (AICAO).

objectiveTo compare clinical outcomes and efficacy of EC-IC bypass surgery in patients with and without recurrent hemispheric syndromes associated with AICAO in the Carotid Occlusion Surgery Study (COSS).

methodsIn patients enrolled in the COSS trial, we compared baseline characteristics and clinical outcomes for participants with (rHEMI+) and without recurrent hemispheric ischemia (rHEMI-) prior to randomization into surgical vs medical groups. The primary outcome was all stroke and death from randomization through 30 d and ipsilateral ischemic stroke within 2 yr.

resultsOf 195 randomized participants, 100 were rHEMI+ (50 in each group). Baseline characteristics between rHEMI+ and rHEMI- participants were similar except rHEMI+ were more likely to have had previous stroke prior to randomization (61% vs 20%, P < .01) and to have TIA as the entry event (59% vs 21%, P < .01). All primary endpoints were ipsilateral ischemic strokes. There were no significant differences in occurrence of the primary endpoint between nonsurgical and surgical participants in rHEMI+ (26.3% vs 22.4%, P = .660) and rHEMI- (18.9% vs 19.5%, P = .943). For nonsurgical participants, there was no significant difference in the primary endpoint for rHEMI+ vs rHEMI- patients (P = .410).

conclusionPatients with recurrent hemispheric stroke syndromes enrolled in the COSS trial did not show benefit from EC-IC bypass compared to medical treatment. Early aggressive risk factor measures should be prioritized to reduce recurrent strokes in these patients.

Indexed as

AgedCarotid Artery DiseasesCarotid Artery, InternalCarotid StenosisCerebral RevascularizationFemaleHumansMaleMiddle AgedRecurrenceRisk FactorsStrokeSyndromeTreatment OutcomeBypassCarotid occlusionStrokeTreatment

Identifiers

PMID31511891
PMCPMC8527995
OpenAlexW2972989193

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.