Evidence map›Paper›PMID 38386052›Full record

Observational studyClinical neuroradiology2024

Benefits of First Pass Recanalization in Basilar Strokes Based on Initial Clinical Severity.

Vincent Brissette, Danielle Carole Roy, Mobin Jamal, Maria Fahmy, Adrien Guenego, Joud Fahed, Michel Shamy, Dar Dowlatshahi, Robert Fahed

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Clinical neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 18% 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

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. 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

9 authors at 4 institutions in 3 countries.

Vincent BrissetteDepartment of Medicine (Neurology), Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.ORCID http://orcid.org/0000-0002-1190-2726
Danielle Carole RoySchool of Epidemiology and Public Health, Faculty of Medicine, Ottawa, Ontario, Canada.ORCID http://orcid.org/0000-0001-9154-4123
Mobin JamalDepartment of Medicine (Neurology), Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Maria FahmyDepartment of Medicine (Neurology), Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Adrien GuenegoInterventional Neuroradiology, Erasme Hospital, Brussels, Belgium.
Joud FahedDepartment of Medicine (Neurology), Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.ORCID http://orcid.org/0009-0006-9985-2271
Michel ShamyDepartment of Medicine (Neurology), Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Dar DowlatshahiDepartment of Medicine (Neurology), Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.ORCID http://orcid.org/0000-0003-1379-3612
Robert FahedDepartment of Medicine (Neurology), Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. robert.fahed@hotmail.fr.
Ottawa Hospital · CAErasmus Hospital · BEOttawa Public Health · CAUniversity College Dublin · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRandomized trials demonstrating the benefits of thrombectomy for basilar artery occlusions have enrolled an insufficient number of patients with a National Institutes for Health Stroke Scale (NIHSS) score < 10 and shown discrepant results for patients with an NIHSS > 20. Achieving a first pass recanalization (FPR) improves clinical outcomes in stroke. We aimed to evaluate the effect of the FPR on outcomes among basilar artery occlusion patients, characterized by prethrombectomy initial NIHSS score.

methodsWe retrospectively analyzed the Endovascular Treatment in Ischemic Stroke (ETIS) registry of 279 basilar artery occlusion patients treated with thrombectomy from 6 participating centers. We compared the 90-day clinical outcomes of achieving a FPR versus no FPR, categorized by initial clinical severity: mild (NIHSS < 10), moderate (NIHSS 10-20) and severe (NIHSS > 20). We used Poisson regression with robust error variance to determine the effect of the NIHSS score on the association between FPR and outcomes.

resultsThe FPR patients with NIHSS < 10 or NIHSS 10-20 were more likely to have a favorable clinical outcome (modified Rankin scale, mRS 0-3) than non-FPR patients (relative risk, RR = 1.32, 95% confidence interval, CI: 1.04, 1.66, p-value = 0.0213, and RR = 1.79, 95% CI: 1.26, 2.53, p-value = 0.0011, respectively). A similar benefit was not found in patients with severe symptoms. We found a significantly lower risk of poor clinical outcome (mRS 4-6) in FPR patients with NIHSS 10-20, but not among patients with an NIHSS > 20.

conclusionAchieving a FPR in basilar artery occlusion patients with mild (NIHSS < 10) or moderate (NIHSS 10-20) symptoms is associated with better clinical outcomes, but not in patients with severe symptoms. These results support the importance of further clinical trials on the benefits of thrombectomy in severe strokes.

Indexed as

Basilar ArteryEndovascular ProceduresIschemic StrokeSeverity of Illness IndexThrombectomyAgedFemaleHumansMaleMiddle AgedRegistriesRetrospective StudiesTreatment OutcomeVertebrobasilar InsufficiencyBasilar strokeClinical outcomeFirst pass effectFirst pass recanalizationMortalityThrombectomy

Identifiers

PMID38386052
OpenAlexW4392049336

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.