Evidence map›Paper›PMID 37813673›Full record

ArticleJournal of stroke2023

Mode of Imaging Study and Endovascular Therapy for a Large Ischemic Core: Insights From the RESCUE-Japan LIMIT.

Fumihiro Sakakibara, Kazutaka Uchida, Shinichi Yoshimura, Nobuyuki Sakai, Hiroshi Yamagami, Kazunori Toyoda, Yuji Matsumaru, Yasushi Matsumoto, Kazumi Kimura, Reiichi Ishikura and 10 more

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In one paragraph

Article in Journal of stroke, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 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.

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, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. 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

20 authors.

Fumihiro SakakibaraDepartment of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan.
Kazutaka UchidaDepartment of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan.
Shinichi YoshimuraDepartment of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan.
Nobuyuki SakaiNeurovascular Research & Neuroendovascular Therapy, Kobe City Medical Center General Hospital, Kobe, Japan.
Hiroshi YamagamiDepartment of Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Kazunori ToyodaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Yuji MatsumaruDivision of Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Yasushi MatsumotoDivision of Development and Discovery of Interventional Therapy, Tohoku University Hospital, Sendai, Japan.
Kazumi KimuraDepartment of Neurology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
Reiichi IshikuraDepartment of Diagnostic Radiology, Kobe City Medical Center General Hospital, Kobe, Japan.
Manabu InoueDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Kumiko AndoDepartment of Diagnostic Radiology, Kobe City Medical Center General Hospital, Kobe, Japan.
Atsushi YoshidaDepartment of Diagnostic Radiology, Kobe City Medical Center General Hospital, Kobe, Japan.
Kanta TanakaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Takeshi YoshimotoDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Junpei KogeDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Mikiya BeppuDepartment of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan.
Manabu ShirakawaDepartment of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan.
Takeshi MorimotoDepartment of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan.
RESCUE-Japan LIMIT InvestigatorsDepartment of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan.

Funding

Japanese Society for Neuroendovascular TherapyMihara Cerebrovascular Disorder Research Promotion Fund
6 · The paper itself

Abstract

background and purposeDifferences in measurement of the extent of acute ischemic stroke using the Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) by non-contrast computed tomography (CT-ASPECTS stratum) and diffusion-weighted imaging (DWI-ASPECTS stratum) may impact the efficacy of endovascular therapy (EVT) in patients with a large ischemic core.

methodsThe RESCUE-Japan LIMIT (Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism Japan-Large IscheMIc core Trial) was a multicenter, open-label, randomized clinical trial that evaluated the efficacy and safety of EVT in patients with ASPECTS of 3-5. CT-ASPECTS was prioritized when both CT-ASPECTS and DWI-ASPECTS were measured. The effects of EVT on the modified Rankin Scale (mRS) score at 90 days were assessed separately for each stratum.

resultsAmong 183 patients, 112 (EVT group, 53; No-EVT group, 59) were in the CT-ASPECTS stratum and 71 (EVT group, 40; No-EVT group, 31) in the DWI-ASPECTS stratum. The common odds ratio (OR) (95% confidence interval) of the EVT group for one scale shift of the mRS score toward 0 was 1.29 (0.65-2.54) compared to the No-EVT group in CT-ASPECTS stratum, and 6.15 (2.46-16.3) in DWI-ASPECTS stratum with significant interaction between treatment assignment and mode of imaging study (P=0.002). There were significant interactions in the improvement of the National Institutes of Health Stroke Scale score at 48 hours (CT-ASPECTS stratum: OR, 1.95; DWIASPECTS stratum: OR, 14.5; interaction P=0.035) and mortality at 90 days (CT-ASPECTS stratum: OR, 2.07; DWI-ASPECTS stratum: OR, 0.23; interaction P=0.008).

conclusionPatients with ASPECTS of 3-5 on MRI benefitted more from EVT than those with ASPECTS of 3-5 on CT.

Indexed as

Acute ischemic strokeEndovascular therapyLarge ischemic coreLarge vessel occlusionNeuroimaging

Identifiers

PMID37813673
PMCPMC10574299

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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.