Evidence map›Paper›PMID 38836274›Full record

ArticleJournal of stroke2024

Endovascular Therapy in the Extended Time Window for Large Vessel Occlusion in Patients With Pre-Stroke Disability.

Kanta Tanaka, Hiroshi Yamagami, Muhammad M Qureshi, Kazutaka Uchida, James E Siegler, Raul G Nogueira, Shinichi Yoshimura, Nobuyuki Sakai, Nicolas Martinez-Majander, Simon Nagel and 48 more

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In one paragraph

Article in Journal of stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

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

58 authors.

Kanta TanakaDivision of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan.
Hiroshi YamagamiDivision of Stroke Prevention and Treatment, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Muhammad M QureshiDepartment of Radiology, Radiation Oncology, Boston Medical Center, Boston, MA, USA.
Kazutaka UchidaDepartment of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan.
James E SieglerDepartment of Neurology, University of Chicago, Chicago, IL, USA.
Raul G NogueiraDepartment of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Shinichi YoshimuraDepartment of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan.
Nobuyuki SakaiDepartment of Neurosurgery, Kobe City Medical General Hospital, Kobe, Japan.
Nicolas Martinez-MajanderDepartment of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Simon NagelDepartment of Neurology, Klinikum Ludwigshafen, Heidelberg University Hospital, Ludwigshafen, Germany.
Jelle DemeestereDepartment of Neurology, Leuven University Hospital, Leuven, Belgium.
Volker PuetzDepartment of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Diogo C HaussenDepartment of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
Mohamad AbdalkaderDepartment of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Marta Olive-GadeaDepartment of Neurology, Hospital Vall d'Hebron, Barcelona, Spain.
Mahmoud H MohammadenDepartment of Neurology, Grady Memorial Hospital, Atlanta, GA, USA.
João Pedro MartoDepartment of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Anne DusartDepartment of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
Simon WinzerDepartment of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Liisa TomppoDepartment of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Francois CaparrosDepartment of Neurology, Centre Hospitalier Universitaire de Lille, University of Lille, Lille, France.
Hilde HenonDepartment of Neurology, Centre Hospitalier Universitaire de Lille, University of Lille, Lille, France.
Flavio BellanteDepartment of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
João Nuno RamosDepartment of Neuroradiology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Santiago Ortega-GutierrezDepartment of Neurology, University of Iowa, Iowa City, IA, USA.
Sunil A ShethDepartment of Neurology, UTHealth Houston, Houston, TX, USA.
Stefania NannoniDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Johannes KaesmacherInstitute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland.
Lieselotte VandewalleDepartment of Neurology, Leuven University Hospital, Leuven, Belgium.
Sergio Salazar-MarioniDepartment of Neurology, UTHealth Houston, Houston, TX, USA.
Mudassir FarooquiDepartment of Neurology, University of Iowa, Iowa City, IA, USA.
Pekka VirtanenDepartment of Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Rita VenturaDepartment of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Syed ZaidiDepartment of Neurology, University of Toledo, Toledo, OH, USA.
Alicia C CastonguayDepartment of Neurology, University of Toledo, Toledo, OH, USA.
Ajit S PuriDivision of Interventional Neuroradiology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA.
Behzad FarzinDepartment of Radiology, Centre Hospitalier de l'Universite de Montreal, Montreal, Canada.
Hesham E MasoudDepartment of Neurology, State University of New York, Upstate Medical University, Syracuse, NY, USA.
Piers KleinDepartment of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Jessica JesserDepartment of Radiology, Heidelberg University Hospital, Heidelberg, Germany.
Manuel RequenaDepartment of Neurology, Hospital Vall d'Hebron, Barcelona, Spain.
Tomas DobrockyInstitute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland.
Daniel P O KaiserDepartment of Diagnostic and Interventional Neuroradiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Erno PeltolaDepartment of Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Davide StramboDepartment of Neurology, Lausanne University Hospital, Lausanne, Switzerland.
Markus A MöhlenbruchDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Eugene LinNeuroscience and Stroke Program, Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH, USA.
Peter A RinglebDepartment of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
Osama O ZaidatNeuroscience and Stroke Program, Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH, USA.
Charlotte CordonnierDepartment of Neurology, Centre Hospitalier Universitaire de Lille, University of Lille, Lille, France.
Daniel RoyDepartment of Radiology, Centre Hospitalier de l'Universite de Montreal, Montreal, Canada.
Robin LemmensDepartment of Neurology, Leuven University Hospital, Leuven, Belgium.
Marc RiboDepartment of Neurology, Hospital Vall d'Hebron, Barcelona, Spain.
Daniel StrbianDepartment of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Urs FischerDepartment of Neurology, University Hospital Basel, Switzerland.
Patrik MichelDepartment of Neurology, Lausanne University Hospital, Lausanne, Switzerland.
Jean RaymondDepartment of Radiology, Centre Hospitalier de l'Universite de Montreal, Montreal, Canada.
Thanh N NguyenDepartment of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.

Funding

Japan Agency for Medical Research and DevelopmentJapanese Society for Neuroendovascular TherapyMedtronicMinistry of Health, Labour and WelfareSociety of Vascular and Interventional NeurologyTakeda Science Foundation
6 · The paper itself

Abstract

background and purposeWe compared the outcomes of endovascular therapy (EVT) in an extended time window in patients with large-vessel occlusion (LVO) between patients with and without pre-stroke disability.

methodsIn this prespecified analysis of the multinational CT for Late Endovascular Reperfusion study (66 participating sites, 10 countries between 2014 and 2022), we analyzed data from patients with acute ischemic stroke with a pre-stroke modified Rankin Scale (mRS) score of 0-4 and LVO who underwent EVT 6-24 hours from the time last seen well. The primary outcome was the composite of functional independence (FI; mRS score 0-2) or return to the pre-stroke mRS score (return of Rankin, RoR) at 90 days. Outcomes were compared between patients with pre-stroke disability (pre-stroke mRS score 2-4) and those without (mRS score 0-1).

resultsA total of 2,231 patients (median age, 72 years; median National Institutes of Health Stroke Scale score, 16) were included in the present analysis. Of these, 564 (25%) had pre-stroke disability. The primary outcome (FI or RoR) was observed in 30.7% of patients with pre-stroke disability (FI, 16.5%; RoR, 30.7%) compared to 44.1% of patients without (FI, 44.1%; RoR, 13.0%) (P<0.001). In multivariable logistic regression analysis with inverse probability of treatment weighting, pre-stroke disability was not associated with significantly lower odds of achieving FI or RoR (adjusted odds ratio 0.73, 95% confidence interval 0.43-1.25). Symptomatic intracranial hemorrhage occurred in 6.3% of both groups (P=0.995).

conclusionA considerable proportion of patients with late-presenting LVO and pre-stroke disability regained pre-stroke mRS scores after EVT. EVT may be appropriate for patients with pre-stroke disability presenting in the extended time window.

Indexed as

Activities of daily livingEndovascular therapyIschemic strokeOutcomeReperfusion

Identifiers

PMID38836274
PMCPMC11164586

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