Evidence map›Paper›PMID 38753954›Full record

ArticleStroke2024

Endovascular Versus Medical Therapy in Posterior Cerebral Artery Stroke: Role of Baseline NIHSS Score and Occlusion Site.

Davide Strambo, Patrik Michel, Thanh N Nguyen, Mohamad Abdalkader, Muhammad M Qureshi, Daniel Strbian, Christian Herweh, Markus A Möhlenbruch, Silja Räty, Marta Olivé-Gadea and 74 more

Registry-linked trialAbstract readMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05291637 (Endovascular Therapy vs Medical Management of PosterIor Cerebral Artery Occlusion Stroke), which is not on this map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 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.

NCT05291637 completednot on this map

Endovascular Therapy vs Medical Management of PosterIor Cerebral Artery Occlusion Stroke

TypeobservationalSponsorBoston Medical CenterRan2022 to 2023Enrolled1,282ConditionsStroke, Acute Ischemic
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  7. Observational
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  15. Observational
  16. Endovascular Treatment for Basilar Artery Occlusion.Journal of clinical medicine · 2024
    Review
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

84 authors.

Davide StramboService of Neurology, Department of Clinical Neurosciences, University Hospital of Lausanne and University of Lausanne, Switzerland (D. Strambo, P.M.).ORCID 0000-0003-4429-2714
Patrik MichelService of Neurology, Department of Clinical Neurosciences, University Hospital of Lausanne and University of Lausanne, Switzerland (D. Strambo, P.M.).ORCID 0000-0003-4954-7579
Thanh N NguyenNeurology (T.N.N., J.C.), Boston Medical Center, MA.ORCID 0000-0002-2810-1685
Mohamad AbdalkaderRadiology (T.N.N., M.A., M.M.Q., P.K., H.D.), Boston Medical Center, MA.ORCID 0000-0002-9528-301X
Muhammad M QureshiRadiology (T.N.N., M.A., M.M.Q., P.K., H.D.), Boston Medical Center, MA.ORCID 0000-0002-2056-3308
Daniel StrbianNeurology (D. Strbian, S.R.), Helsinki University Hospital, University of Helsinki, Finland.ORCID 0000-0001-9095-2344
Christian HerwehNeuroradiology (C.H., M.A.M., J.J.), Heidelberg University Hospital, Germany.ORCID 0000-0002-9223-9662
Markus A MöhlenbruchNeuroradiology (C.H., M.A.M., J.J.), Heidelberg University Hospital, Germany.
Silja RätyNeurology (D. Strbian, S.R.), Helsinki University Hospital, University of Helsinki, Finland.ORCID 0000-0002-6921-0597
Marta Olivé-GadeaNeurology, Hospital Universitario Vall d'Hebron, Barcelona, Spain (M.O.-G., M. Ribo, M. Requena).
Marc RiboNeurology, Hospital Universitario Vall d'Hebron, Barcelona, Spain (M.O.-G., M. Ribo, M. Requena).
Marios PsychogiosRadiology, Basel University Hospital, University of Basel, Switzerland (M.P., A.N.).
Urs FischerDepartment of Neurology, University Hospital and University of Bern, Switzerland (U.F.).
Anh NguyenRadiology, Basel University Hospital, University of Basel, Switzerland (M.P., A.N.).
Joji B KuramatsuNeurology (J.B.K, D.H.), University of Erlangen-Nuremberg, Germany.
David HaupenthalNeurology (J.B.K, D.H.), University of Erlangen-Nuremberg, Germany.
Martin KöhrmannNeurology, Institute of Diagnostic and Interventional Radiology (M. Köhrmann, J.K.E.), University Hospital Essen, Germany.
Cornelius DeuschlNeuroradiology (C.D.), University Hospital Essen, Germany.
Jordi Kühne EscolàNeurology, Institute of Diagnostic and Interventional Radiology (M. Köhrmann, J.K.E.), University Hospital Essen, Germany.
Jelle DemeestereNeurology, UZ Leuven, Belgium (J.D., R. Lemmens, L.V.).
Robin LemmensNeurology, UZ Leuven, Belgium (J.D., R. Lemmens, L.V.).
Lieselotte VandewalleNeurology, UZ Leuven, Belgium (J.D., R. Lemmens, L.V.).
Shadi YaghiNeurology, Rhode Island Hospital (S.Y., L.S.).
Liqi ShuNeurology, Rhode Island Hospital (S.Y., L.S.).
Volker PuetzNeurology (V.P.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
Daniel P O KaiserNeuroradiology (D.P.O.K.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
Johannes KaesmacherInstitute of Diagnostic and Interventional Neuroradiology, University Hospital Bern Inselspital, University of Bern, Switzerland (J.K., A. Mujanovic, B.S.).
Adnan MujanovicInstitute of Diagnostic and Interventional Neuroradiology, University Hospital Bern Inselspital, University of Bern, Switzerland (J.K., A. Mujanovic, B.S.).
Dominique Cornelius MarterstockNeuroradiology (D.C.M., T.E.), University of Erlangen-Nuremberg, Germany.
Tobias EngelhornNeuroradiology (D.C.M., T.E.), University of Erlangen-Nuremberg, Germany.
Manuel RequenaNeuroradiology (D.P.O.K.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
Hormuzdiyar H DasenbrockRadiology (T.N.N., M.A., M.M.Q., P.K., H.D.), Boston Medical Center, MA.
Piers KleinRadiology (T.N.N., M.A., M.M.Q., P.K., H.D.), Boston Medical Center, MA.
Diogo C HaussenNeurology, Grady Memorial Hospital (D.C.H., M.H.M., H.A., L.S.V.).
Mahmoud H MohammadenNeurology, Grady Memorial Hospital (D.C.H., M.H.M., H.A., L.S.V.).
Hend AbdelhamidNeurology, Grady Memorial Hospital (D.C.H., M.H.M., H.A., L.S.V.).
Lorena Souza VianaNeurology, Grady Memorial Hospital (D.C.H., M.H.M., H.A., L.S.V.).
Bruno CunhaNeuroradiology, Centro Hospitalar Universitario de Lisboa Central, Portugal (B.C., I.F.).
Isabel FragataNeuroradiology, Centro Hospitalar Universitario de Lisboa Central, Portugal (B.C., I.F.).
Michele RomoliNeurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Cesena, Italy (M. Romoli).
Francesco DianaNeuroradiology, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy (F.D.).
Wei HuNeurology, The First Affiliated Hospital of USTC, Hefei, China (W.H., C.Z.).
Chao ZhangNeurology, The First Affiliated Hospital of USTC, Hefei, China (W.H., C.Z.).
Pekka VirtanenRadiology (P.V., R. Lauha, K.L.), Helsinki University Hospital, University of Helsinki, Finland.
Riikka LauhaRadiology (P.V., R. Lauha, K.L.), Helsinki University Hospital, University of Helsinki, Finland.
Jessica JesserNeuroradiology (C.H., M.A.M., J.J.), Heidelberg University Hospital, Germany.
Judith ClarkNeurology (T.N.N., J.C.), Boston Medical Center, MA.
Stavros MatsoukasNeurosurgery, Mount Sinai Health System (S.M., J.T.F.).
Johanna T FifiNeurosurgery, Mount Sinai Health System (S.M., J.T.F.).
Sunil A ShethNeurology, McGovern Medical School at UTHealth, TX (S.A.S., S.S.-M.).
Sergio Salazar-MarioniNeurology, McGovern Medical School at UTHealth, TX (S.A.S., S.S.-M.).
João Pedro MartoNeurology (J.P.M.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal.
João Nuno RamosNeuroradiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal.
Milena MiszczukNeuroradiology (M. Miszczuk, E.S.), Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
Christoph RieglerDepartement of Neurology and Experimental Neurology, and Center for Stroke Research Berlin (C.R., C.H.N.), Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
Sven PoliDepartment of Neurology and Stroke (S.P., K.P.), University of Tübingen, Germany.
Khouloud PoliDepartment of Neurology and Stroke (S.P., K.P.), University of Tübingen, Germany.
Ashutosh P JadhavNeurosurgery, Barrow Neurological Institute, Phoenix, AZ (A.P.J., S.M.D.).
Shashvat M DesaiNeurosurgery, Barrow Neurological Institute, Phoenix, AZ (A.P.J., S.M.D.).
Volker MausRadiology, Neuroradiology, and Nuclear Medicine, University Hospital Knappschaftskrankenhaus Bochum, Germany (V.M., M.K.).
Maximilian KaederRadiology, Neuroradiology, and Nuclear Medicine, University Hospital Knappschaftskrankenhaus Bochum, Germany (V.M., M.K.).
Adnan H SiddiquiRadiology (T.N.N., M.A., M.M.Q., P.K., H.D.), Boston Medical Center, MA.
Andre MonteiroNeurosurgery, University of Buffalo, NY (A.H.S., A. Monteiro).
Hesham E MasoudNeurology, New York Upstate Medical University (H.E.M.).
Neil SuryadarevaNeurology, University of Pittsburgh Medical Center, PA (N.S., R.G.N.).
Maxim MokinNeurosurgery, University of South Florida, Tampa (M. Mokin, S.T.).
Shail ThankiNeurosurgery, University of South Florida, Tampa (M. Mokin, S.T.).
Kemal AlpayRadiology (K.A.), Turku University Hospital, Finland.
Pauli YlikotilaNeurology (P.Y.), Turku University Hospital, Finland.
James E SieglerNeurology, University of Chicago, IL (J.E.S.).
Italo LinfanteMiami Neuroscience Institute, FL (I.L., G.D.).
Guilherme DabusMiami Neuroscience Institute, FL (I.L., G.D.).
Negar AsdaghiNeurology, University of Miami Miller School of Medicine, FL (N.A., V.S.).
Vasu SainiNeurology, University of Miami Miller School of Medicine, FL (N.A., V.S.).
Christian H NolteDepartement of Neurology and Experimental Neurology, and Center for Stroke Research Berlin (C.R., C.H.N.), Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
Eberhard SiebertNeuroradiology (M. Miszczuk, E.S.), Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
Bettina L SerrallachInstitute of Diagnostic and Interventional Neuroradiology, University Hospital Bern Inselspital, University of Bern, Switzerland (J.K., A. Mujanovic, B.S.).
Charlotte S WeylandNeuroradiology, University Hospital RWTH Aachen, Germany (C.S.W.).
Uta HanningDiagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Germany (U.H., L.M.).
Lukas MeyerDiagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Germany (U.H., L.M.).
Anne BerberichNeurology, Klinikum Ludwigshafen, Germany (A.B., S.N.).
Peter A RinglebNeurology (P.A.R., S.N.), Heidelberg University Hospital, Germany.
Raul G NogueiraNeurology, University of Pittsburgh Medical Center, PA (N.S., R.G.N.).
Simon Nagel

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute ischemic stroke with isolated posterior cerebral artery occlusion (iPCAO) lacks management evidence from randomized trials. We aimed to evaluate whether the association between endovascular treatment (EVT) and outcomes in iPCAO acute ischemic stroke is modified by initial stroke severity (baseline National Institutes of Health Stroke Scale [NIHSS]) and arterial occlusion site.

methodsBased on the multicenter, retrospective, case-control study of consecutive iPCAO acute ischemic stroke patients (PLATO study [Posterior Cerebral Artery Occlusion Stroke]), we assessed the heterogeneity of EVT outcomes compared with medical management (MM) for iPCAO, according to baseline NIHSS score (≤6 versus >6) and occlusion site (P1 versus P2), using multivariable regression modeling with interaction terms. The primary outcome was the favorable shift of 3-month modified Rankin Scale (mRS). Secondary outcomes included excellent outcome (mRS score 0-1), functional independence (mRS score 0-2), symptomatic intracranial hemorrhage, and mortality.

resultsFrom 1344 patients assessed for eligibility, 1059 were included (median age, 74 years; 43.7% women; 41.3% had intravenous thrombolysis): 364 receiving EVT and 695 receiving MM. Baseline stroke severity did not modify the association of EVT with 3-month mRS distribution (

conclusionsBaseline clinical stroke severity, rather than the occlusion site, may be an important modifier of the association between EVT and outcomes in iPCAO. Only severely affected patients with iPCAO (NIHSS score >6) had more favorable disability outcomes with EVT than MM, despite increased mortality and symptomatic intracranial hemorrhage.

Indexed as

Endovascular ProceduresInfarction, Posterior Cerebral ArteryAgedAged, 80 and overCase-Control StudiesFemaleHumansIschemic StrokeMaleMiddle AgedRetrospective StudiesSeverity of Illness IndexStrokeThrombolytic TherapyTreatment Outcomecase-control studiesfunctional statusposterior cerebral arterystrokethrombectomy

Identifiers

PMID38753954
PMCPMC11198954

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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.