Observational studyBMC neurology2020
Stroke patients treated by thrombectomy in real life differ from cohorts of the clinical trials: a prospective observational study.
Observational study in BMC neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled 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.
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
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Safety outcomes in endovascular treatment versus best medical management for basilar artery occlusion acute ischemic stroke: A systematic review and meta-analysis of randomized trials.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Pooled it
- Endovascular Therapy for Stroke Presenting Beyond 24 Hours: A Systematic Review and Meta-analysis.JAMA network open · 2023Pooled it
- Clinical and Procedural Outcomes with or without Balloon Guide Catheters during Endovascular Thrombectomy in Acute Ischemic Stroke: A Systematic Review and Meta-analysis with First-line Technique Subgroup Analysis.AJNR. American journal of neuroradiology · 2021Pooled it
- Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients with Acute Ischemic Stroke Due to Large Vessel Occlusion in Anterior Circulation: Results of a 3-Month Follow-up of a Prospective, Open Label, Single-Center Study.Translational stroke research · 2025Trial
- Study Criteria Applied to Real Life-A Multicenter Analysis of Stroke Patients Undergoing Endovascular Treatment in Clinical Practice.Journal of the American Heart Association · 2021Trial
- Real-World Outcomes of Ischemic Stroke Interventions in Older Patients: A Cohort Study from a Tertiary Medical Center.Healthcare (Basel, Switzerland) · 2026Article
- How Much Is ICAD Required to Justify Rescue Stenting?Clinical neuroradiology · 2025Article
- Enlarged therapeutic window for ischemic stroke in a real life regional experience: is it always a valid approach?Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Semi-automated tortuosity measurements confirm generalizability of IMPERATIVE trial results to real-world patients with acute ischemic stroke undergoing thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Post-Thrombectomy Subarachnoid Hemorrhage: Incidence, Predictors, Clinical Relevance, and Effect Modulators.Diagnostics (Basel, Switzerland) · 2024Article
- Endovascular thrombectomy in patients with anterior circulation stroke: an emulated real-world comparison.Neurological research and practice · 2024Article
- Real world data in mechanical thrombectomy: who are we losing to follow-up?Journal of neurointerventional surgery · 2024Article
- Article
- Mechanical thrombectomy in ischemic stroke after cardiovascular procedures: a propensity-matched cohort analysis.Journal of neurointerventional surgery · 2023Article
- Rescue Stenting for Failed Mechanical Thrombectomy in Acute Ischemic Stroke: Systematic Review and Meta-analysis.Stroke (Hoboken, N.J.) · 2023Article
- Factors Associated With Improved Technical Outcomes When Using 0.068- to 0.074-Inch Aspiration Catheters: Analysis From a Multicenter Retrospective Cohort.Stroke (Hoboken, N.J.) · 2023Article
- Thrombectomy for Large-Vessel Occlusion With Pretreatment Intracranial Hemorrhage.Stroke (Hoboken, N.J.) · 2022Article
- Circulating Cytokines and Growth Factors in Acute Cerebral Large Vessel Occlusion-Association with Success of Endovascular Treatment.Thrombosis and haemostasis · 2022Article
- Mechanical thrombectomy in stroke patients of working age: Real-world outcomes in Sweden.European stroke journal · 2022Article
- The Bigger the Better? Center Volume Dependent Effects on Procedural and Functional Outcome in Established Endovascular Stroke Centers.Frontiers in neurology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRandomized controlled trials (RCTs) demonstrated efficacy and safety of endovascular treatment (ET) in anterior circulation large vessel occlusions (LVO). We aimed at investigating how stroke patients treated by thrombectomy in clinical practice and their outcome compare to cohorts and results of thrombectomy trials.
methodsIn a prospective study, we consecutively included stroke patients treated by thrombectomy (2015-2017). Baseline characteristics, procedural and outcome data were analyzed. Outcome was assessed by modified Rankin Scale (mRS) at 90 days. Ordinal regression analysis was performed to identify predictors of outcome.
resultsThrombectomy was applied in 264 patients (median 75 years, 49.6% female). Median baseline National Institutes of Health Stroke Scale (NIHSS) was 16, 58.0% received concomitant intravenous thrombolysis, 62.1% were referred from external hospitals. Median Alberta Stroke Program Early CT Score (ASPECTS) was 7. Successful recanalization (modified Thrombolysis in Cerebral Infarction Score, mTICI 2b/3) was achieved in 72.0%. Symptomatic intracranial hemorrhage (sICH) occurred in 4.5%. Independent outcome (mRS 0-2) was achieved in 26.2%, poor outcome (mRS 5-6) in 49.2%. Only 33.5% met the stringent enrolment criteria of previous RCTs. Lower age, baseline NIHSS, pre-stroke mRS, higher ASPECTS, and successful recanalization were independent predictors of favourable outcome.
conclusionsThe majority of stroke patients treated by ET in clinical practice would not have qualified for randomization in prior RCTs. Outcome in real-life patient cohorts is worse than in the highly selected cohorts from randomized trials, while rates of successful recanalization, sICH and outcome predictors are the same. Our findings support ET in broader patient populations than in the RCTs and may improve treatment decision in individual stroke patients with LVO in clinical practice.
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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.