Evidence map›Paper›PMID 38497536›Full record

ArticleEuropean stroke journal2024

Absent leptomeningeal collateralization is associated with greatest benefit from mechanical thrombectomy in the 6-24 hour time window.

Tolga D Dittrich, Tennessee von Streng, Anna M Toebak, Annaelle Zietz, Benjamin Wagner, Martin Hänsel, Raoul Sutter, Mira Katan, Nils Peters, Lars Michels and 8 more

Abstract readMulticenter Study
In one paragraph

Article in European stroke journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Tolga D DittrichDepartment of Neurology and Stroke Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.ORCID 0000-0002-9987-3631
Tennessee von StrengDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Anna M ToebakDepartment of Neurology and Stroke Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.ORCID 0009-0004-1006-9113
Annaelle ZietzDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0002-4362-2497
Benjamin WagnerDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0001-9330-1790
Martin HänselDepartment of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
Raoul SutterDepartment of Clinical Research, University of Basel, Basel, Switzerland.
Mira KatanDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Nils PetersDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Lars MichelsDepartment of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.
Zsolt KulcsárDepartment of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.
Grzegorz M KarwackiDepartment of Radiology and Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Marco PileggiDepartment of Neuroradiology EOC, Neurocenter of Southern Switzerland, Lugano, Switzerland.
Carlo W CeredaDepartment of Neurology and Stroke Center EOC, Neurocenter of Southern Switzerland, Lugano, Switzerland.
Susanne WegenerDepartment of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.ORCID 0000-0003-4369-7023
Leo H BonatiDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Marios PsychogiosDepartment of Clinical Research, University of Basel, Basel, Switzerland.
Gian Marco De MarchisDepartment of Neurology and Stroke Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe impact of leptomeningeal collateralization on the efficacy of mechanical thrombectomy (MT) in patients with anterior circulation large vessel occlusion (aLVO) presenting in the 6-24 h time window remains poorly elucidated. PATIENTS AND

methodsRetrospective multicenter study of aLVO patients presenting between 6 and 24 h after stroke onset who received MT plus Best Medical Treatment (BMT) or BMT alone. Leptomeningeal collateralization was assessed using single-phase computed tomography angiography (grade 0: no filling; grade 1: filling ⩽50%; grade 2: filling >50% but <100%; grade 3: filling 100% of the occluded territory). Inverse probability of treatment weighted ordinal regression was performed to assess the association between treatment and shift of the modified Rankin Scale (mRS) score toward lower categories at 3 months. We used interaction analysis to explore differential treatment effects on functional outcomes (probabilities for each mRS subcategory at 3 months) at different collateral grades.

resultsAmong 363 included patients, 62% received MT + BMT. Better collateralization was associated with better functional outcomes at 3 months in the BMT alone group (collateral grade 1 vs 0: acOR 5.06, 95% CI 2.33-10.99). MT + BMT was associated with higher odds of favorable functional outcome at 3 months (acOR 1.70, 95% CI 1.11-2.62) which was consistent after adjustment for collateral status (acOR 1.54, 95% CI 1.01-2.35). Regarding treatment effect modification, patients with absent collateralization had higher probabilities for a mRS of 0-4 and a lower mortality at 3 months for the MT + BMT group. DISCUSSION AND

conclusionIn the 6-to-24-h time window, aLVO patients with absent leptomeningeal collateralization benefit most from MT + BMT, indicating potential advantages for this group despite their poorer baseline prognosis.

Indexed as

Collateral CirculationThrombectomyAgedAged, 80 and overComputed Tomography AngiographyFemaleHumansIschemic StrokeMaleMeningesMiddle AgedRetrospective StudiesTime-to-TreatmentTreatment OutcomecoreIschemic strokelarge vessel occlusionlate windowthrombectomy

Identifiers

PMID38497536
PMCPMC11418553

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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.