Evidence map›Paper›PMID 34269121›Full record

ArticleThe neuroradiology journal2022

Trends in mechanical thrombectomy and decompressive hemicraniectomy for stroke: A multicenter study.

Chesney S Oravec, Christine Tschoe, Kyle M Fargen, Carol A Kittel, Alejandro Spiotta, Eyad Almallouhi, Robert M Starke, David J McCarthy, Scott Simon, Stephanie Zyck and 11 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The neuroradiology journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.2field-weighted citation impact, top 21% 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

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Article
  3. Targeting BACE1-mediated production of amyloid beta improves hippocampal synaptic function in an experimental model of ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2023
    Article
  4. 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

21 authors at 12 institutions in 1 country.

Chesney S OravecDepartment of Neurosurgery, Wake Forest Baptist Medical Center, USA.ORCID https://orcid.org/0000-0002-4846-7860
Christine TschoeDepartment of Neurosurgery, Wake Forest Baptist Medical Center, USA.
Kyle M FargenDepartment of Neurosurgery, Wake Forest Baptist Medical Center, USA.
Carol A KittelDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, USA.
Alejandro SpiottaMedical University of South Carolina, USA.
Eyad AlmallouhiMedical University of South Carolina, USA.
Robert M StarkeMiami University, USA.
David J McCarthyMiami University, USA.
Scott SimonPennsylvania State University, USA.
Stephanie ZyckState University of New York, USA.
Grahame C GouldState University of New York, USA.
Reade De LeacyMount Sinai Hospital, USA.
J MoccoMount Sinai Hospital, USA.
Adnan SiddiquiUniversity at Buffalo, USA.
Sasha VaziriUniversity of Florida, USA.
W Christopher FoxUniversity of Florida, USA.
Justin F FraserDepartments of Neurological Surgery, Neurology, Radiology, and Neuroscience, University of Kentucky, USA.
Rohan ChitaleVanderbilt University, USA.
Gregory ZipfelWashington University of Saint Louis, USA.
Anna HuguenardWashington University of Saint Louis, USA.
Stacey Q WolfeDepartment of Neurosurgery, Wake Forest Baptist Medical Center, USA.
Atrium Health Wake Forest Baptist · USMedical University of South Carolina · USMiami University · USMount Sinai Hospital · USState University of New York · USUniversity of Florida · USWashington University in St. Louis · USPennsylvania State University · USUniversity at Buffalo, State University of New York · USUniversity of Kentucky · USVanderbilt University · USWake Forest University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeAcute ischemic stroke has increasingly become a procedural disease following the demonstrated benefit of mechanical thrombectomy (MT) for emergent large vessel occlusion (ELVO) on clinical outcomes and tissue salvage in randomized trials. Given these data and anecdotal experience of decreased numbers of decompressive hemicraniectomies (DHCs) performed for malignant cerebral edema, we sought to correlate the numbers of strokes, thrombectomies, and DHCs performed over the timeline of the 2013 failed thrombolysis/thrombectomy trials, to the 2015 modern randomized MT trials, to post-DAWN and DEFUSE 3. MATERIALS AND

methodsThis is a multicenter retrospective compilation of patients who presented with ELVO in 11 US high-volume comprehensive stroke centers. Rates of tissue plasminogen activator (tPA), thrombectomy, and DHC were determined by current procedural terminology code, and specificity to acute ischemic stroke confirmed by each institution. Endpoints included the incidence of stroke, thrombectomy, and DHC and rates of change over time.

resultsBetween 2013 and 2018, there were 55,247 stroke admissions across 11 participating centers. Of these, 6145 received tPA, 4122 underwent thrombectomy, and 662 patients underwent hemicraniectomy. The trajectories of procedure rates over time were modeled and there was a significant change in MT rate (

conclusionsThis real-world study confirms an increase in thrombectomy performed for ELVO while demonstrating stable rates of stroke admission, tPA administration and DHC. Unlike prior studies, increasing thrombectomy rates were not associated with decreased utilization of hemicraniectomy.

Indexed as

Brain IschemiaIschemic StrokeStrokeHumansRetrospective StudiesThrombectomyTissue Plasminogen ActivatorTreatment OutcomeTissue Plasminogen Activatoracute ischemic strokeDecompressive craniectomyendovascular therapyhemicraniectomymalignant cerebral edemamechanical thrombectomy

Identifiers

PMID34269121
PMCPMC9130608
OpenAlexW3182500909

What OpenQuestion holds

Textmetadata
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Registered trials

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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.