Evidence map›Paper›PMID 33469657›Full record

Trial reportNeurosurgery2021

Encephaloduroarteriosynangiosis Averts Stroke in Atherosclerotic Patients With Border-Zone Infarct: Post Hoc Analysis From a Performance Criterion Phase II Trial.

Miguel D Quintero-Consuegra, Juan F Toscano, Robin Babadjouni, Peyton Nisson, Mohammad N Kayyali, Daniel Chang, Eyad Almallouhi, Jeffrey L Saver, Nestor R Gonzalez

Open access · greenAbstract readClinical Trial, Phase IIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 19% 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

5 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. RNA profiling of sEV (small extracellular vesicles)/exosomes reveals biomarkers and vascular endothelial dysplasia with moyamoya disease.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2023
    Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Miguel D Quintero-ConsuegraDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
Juan F ToscanoDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
Robin BabadjouniDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
Peyton NissonDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
Mohammad N KayyaliDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, California.
Daniel ChangDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
Eyad AlmallouhiDepartment of Neurology, Medical University of South Carolina, Charleston, South Carolina.
Jeffrey L SaverDepartment of Neurology, University of California, Los Angeles, Los Angeles, California.
Nestor R GonzalezDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
Cedars-Sinai Medical Center · USMedical University of South Carolina · USUniversity of California, Los Angeles · US

Funding

Surgical Indirect Revascularization For Symptomatic Intracranial Aterial StenosisK23NS079477 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI GONZALEZ, NESTOR RAUL · 2013 to 2017
$842k
NINDS NIH HHS K23 NS079477
6 · The paper itself

Abstract

backgroundIntracranial atherosclerotic disease (ICAD) is one of the leading causes of stroke worldwide. Patients with ICAD who initially present with ischemia in border-zone areas and undergo intensive medical management (IMM) have the highest recurrence rates (37% at 1 yr) because of association with hemodynamic failure and poor collaterals.

objectiveTo evaluate the effect of encephaloduroarteriosynagiosis (EDAS) on stroke recurrence in patients with ICAD and border-zone stroke (BDZS) at presentation.

methodsA phase II clinical trial of EDAS revascularization for symptomatic ICAD failing medical management (EDAS Revascularization for Symptomatic Intracranial Atherosclerosis Steno-occlusive [ERSIAS]) was recently concluded. We analyze the outcomes of the subgroup of patients with BDZS at presentation treated with EDAS vs the previously reported Stenting versus Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) IMM subgroup with BDZS at presentation.

resultsOf 52 patients included in the ERSIAS trial, 35 presented with strokes at baseline, and 28 had a BDZ pattern, including 15 (54%) with exclusive BDZS and 13 (46%) with mixed patterns (BDZ plus other distribution). Three of the 28 (10.7%) had recurrent strokes up to a median follow-up of 24 months. The rate of recurrent stroke in ICAD patients with BDZS at presentation after EDAS was significantly lower than the rate reported in the SAMMPRIS IMM subgroup with BDZS at presentation (10.7% vs 37% P = .004, 95% CI = 0.037-0.27).

conclusionICAD patients with BDZS at presentation have lower rates of recurrent stroke after EDAS surgery than those reported with medical management in the SAMMPRIS trial. These results support further investigation of EDAS in a randomized clinical trial.

Indexed as

AdultAgedCerebral InfarctionCerebral RevascularizationFemaleFollow-Up StudiesHumansIntracranial ArteriosclerosisMaleMiddle AgedProspective StudiesStentsStrokeTreatment OutcomeBorder-zone strokeEDASIntracranial atherosclerosisStroke

Identifiers

PMID33469657
PMCPMC7956046
OpenAlexW3124475215

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.