Evidence map›Paper›PMID 37430361›Full record

Trial reportEuropean journal of medical research2023

Impact of anesthesia modalities on functional outcome of mechanical thrombectomy in patients with acute ischemic stroke: a subgroup analysis of DIRECT-MT trial.

Zifu Li, Hongyu Ma, Binben Li, Lei Zhang, Yongwei Zhang, Pengfei Xing, Yongxin Zhang, Xiaoxi Zhang, Yu Zhou, Qinghai Huang and 8 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of medical research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03469206 (Parallel Group, Randomized Clinical Trial of Direct Intra-arterial Thrombectomy Versus Intravenous Thrombolysis With Intra-arterial Thrombectomy for Patients With Large Vessel Occlusion of the Anterior Circulation), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

NCT03469206 nacompletednot on this map

Parallel Group, Randomized Clinical Trial of Direct Intra-arterial Thrombectomy Versus Intravenous Thrombolysis With Intra-arterial Thrombectomy for Patients With Large Vessel Occlusion of the Anterior Circulation

TypeinterventionalSponsorChanghai HospitalRan2018 to 2019Enrolled656ConditionsIschemic Stroke, Large Vessel Occlusion, Thrombectomy, ThrombosisArmsintra-arterial thrombectomy, Intravenous thrombolysis
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Trial
  3. 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

18 authors.

Zifu Li *Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Hongyu Ma *Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Binben Li *Department of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Lei ZhangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Yongwei ZhangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Pengfei XingNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Yongxin ZhangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Xiaoxi ZhangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Yu ZhouNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Qinghai HuangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Qiang LiNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Qiao ZuoNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Xiaofei YeNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Jianmin LiuNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Adnan I QureshiZeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, USA.
Wenhuo ChenDepartment of Neurology, Municipal Hospital of Zhangzhou, Zhangzhou, Fujian Province, China. doctorwwenhuo@126.com.
Pengfei YangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China. p.yang@vip.163.com.
DIRECT-MT Investigators

Funding

National Health Commission of the People's Republic of China GN-2017R0001Science and Technology Commission of Shanghai Municipality 124119a8900Shanghai Municipal Health and Family Planning Commission 201640094
6 · The paper itself

Abstract

backgroundThis subgroup analysis of Direct Intraarterial Thrombectomy in Order to Revascularize Acute Ischemic Stroke Patients with Large Vessel Occlusion Efficiently in Chinese Tertiary Hospitals Multicenter Randomized Clinical Trial (DIRECT-MT) aimed to investigate the influence of anesthesia modalities on the outcomes of endovascular treatment.

methodsPatients were divided into two groups by receiving general anesthesia (GA) or non-general anesthesia (non-GA). The primary outcome was assessed by the between-group difference in the distribution of the modified Rankin Scale (mRS) at 90 days, estimated using the adjusted common odds ratio (acOR) by multivariable ordinal regression. Differences in workflow efficiency, procedural complication, and safety outcomes were analyzed.

resultsTotally 636 patients were enrolled (207 for GA and 429 for non-GA groups). There was no significant shift in the mRS distribution at 90 days between the two groups (acOR, 1.093). The median time from randomization to reperfusion was significantly longer in GA group (116 vs. 93 min, P < 0.0001). Patients in non-GA group were associated with a significantly lower NIHSS score at early stages (24 h, 11 vs 15; 5-7 days or discharge, 6.5 vs 10). The rate of severe manipulation-related complication did not differ significantly between GA and non-GA groups (0.97% vs 3.26%; P = 0.08). There are no differences in the rate of mortality and intracranial hemorrhage.

conclusionsIn the subgroup analysis of DIRECT-MT, we found no significant difference in the functional outcome at 90 days between general anesthesia and non-general anesthesia, despite the workflow time being significantly delayed for patients with general anesthesia. Clinical trail registration clinicaltrials.gov Identifier: NCT03469206.

Indexed as

AnesthesiaIschemic StrokeThrombectomyHumansAcute ischemic strokeAnesthesiaMechanical thrombectomyOutcome

Identifiers

PMID37430361
PMCPMC10332003

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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.