SynthesisClinical neuroradiology2024
Endovascular Thrombectomy for Large Ischemic Strokes with ASPECTS 0-2: a Meta-analysis of Randomized Controlled Trials.
Synthesis in Clinical neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Endovascular thrombectomy with or without intravenous alteplase in large-core ischemic stroke: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Pooled it
- Endovascular Therapy for Acute Ischemic Stroke: Current Evidence and Evolving Practices.Current cardiology reports · 2026Review
- RAPID-LC: rapid evidence-to-practice uptake of large core thrombectomy across a stroke consortium.Journal of neurology · 2026Article
- [Focus on neurological intensive care medicine 2024/2025-Summary of selected studies in intensive care medicineal care].Die Anaesthesiologie · 2026Article
- Endovascular thrombectomy for acute ischemic stroke: evolving patient selection, procedural strategies, and adjunctive therapies.Frontiers in neurology · 2026Review
- 3-6-24 Anterior Circulation Large Vessel Occlusion-Stroke Screening Rule: A Simple and Feasible Framework.Annals of Indian Academy of Neurology · 2026Article
- Impact of device pass count and reperfusion levels in anterior circulation stroke: differential effects based on large-scale data from clinical practice.Journal of neurology · 2025Article
- Endovascular Therapy in Patients With Acute Ischemic Stroke With Large Infarct: A Guideline From the Society of Vascular and Interventional Neurology.Stroke (Hoboken, N.J.) · 2025Review
- Delayed treatment of severe stroke: room for thrombectomy?European heart journal supplements : journal of the European Society of Cardiology · 2025Article
- Mechanical thrombectomy failure in anterior and posterior circulation stroke: current results from a high-volume comprehensive center.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- [Focus neurological intensive care medicine 2023/2024 : Summary of selected studies in intensive medical care].Die Anaesthesiologie · 2025Article
- Getting to the Core of Stroke.Annals of Indian Academy of Neurology · 2024Article
- Near-Complete Reversal of Large Diffusion-Weighted Imaging Lesion after Thrombectomy: A Case Report and Literature Review.Cerebrovascular diseases extra · 2024Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRandomized controlled trials (RCTs) demonstrated a treatment effect of endovascular thrombectomy in acute ischemic stroke with large infarct, commonly defined as an Alberta Stroke Program Early CT Score (ASPECTS) of 3-5. However, data on endovascular thrombectomy in patients with very low ASPECTS of 0-2 remain scarce.
methodsWe conducted a systematic review and meta-analysis of RCTs comparing endovascular thrombectomy versus medical treatment alone in acute ischemic anterior circulation stroke with very large infarct, defined as ASPECTS of 0-2. The primary outcome was the shift toward better functional outcomes on the 90-day modified Rankin Scale (mRS). Random effects meta-analysis was performed using the generic inverse variance method.
resultsLiterature research identified four RCTs which evaluated the treatment effect of endovascular thrombectomy for large infarcts and provided a subgroup analysis of the mRS shift in patients with ASPECTS of 0-2. The pooled analysis showed a significant shift toward better 90-day mRS scores in favor of endovascular thrombectomy (pooled odds ratio, 1.62, 95% confidence interval, 1.29-2.04, P < 0.001).
conclusionThis meta-analysis suggests a treatment effect of endovascular thrombectomy in specific patients with very low ASPECTS of 0-2, challenging the use of ASPECTS for treatment selection in acute ischemic stroke due to large vessel occlusion. An individual patient meta-analysis of RCTs would strengthen evidence in the treatment of patients with ASPECTS of 0-2.
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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.