Evidence map›Paper›PMID 39075750›Full record

Trial reportInternational journal of stroke : official journal of the International Stroke Society2024

Association of first-line thrombectomy technique and outcome in late-window large vessel occlusion strokes: A post hoc analysis of the MR CLEAN-LATE trial.

Robrecht Rmm Knapen, Susanne Gh Olthuis, Adriaan Cgm van Es, Bart J Emmer, Wouter J Schonewille, Christiaan van der Leij, Wim H van Zwam, Robert J van Oostenbrugge

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of stroke : official journal of the International Stroke Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

  1. Pooled it
  2. 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

8 authors.

Robrecht Rmm KnapenDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0003-4677-3685
Susanne Gh OlthuisDepartment of Neurology, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0002-2802-1511
Adriaan Cgm van EsDepartment of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Bart J EmmerDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Wouter J SchonewilleDepartment of Neurology, St. Antonius Nieuwegein, Nieuwegein, The Netherlands.
Christiaan van der LeijDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.
Wim H van ZwamDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.
Robert J van OostenbruggeDepartment of Neurology, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.ORCID 0000-0003-1032-9099

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to compare direct aspiration, stent retriever, and the combined thrombectomy technique on clinical, safety, and technical outcomes in late-window stroke patients included in the MR CLEAN-LATE trial.

methodsThis post hoc analysis of the MR CLEAN-LATE trial included patients treated with direct aspiration, stent retriever, or combined thrombectomy technique as first-line approach. Primary outcome was the modified Rankin Scale (mRS) score at 90 days follow-up, and compared between the three groups with ordinal logistic regression analysis. Secondary outcomes included mortality at 90 days, total technique switches, procedure time, recanalization rate measured with the expanded thrombolysis in cerebral infarction (eTICI) score, and symptomatic intracranial hemorrhage (sICH). Predefined variables were used for adjustments.

resultsIn the MR CLEAN-LATE trial, 258 patients underwent endovascular treatment and 232 were included in our analyses. The mRS at 90 days did not differ (stent retriever vs. direct aspiration: adjusted common odds ratio (acOR) = 1.35, 95% confidence interval (CI) = 0.73 to 2.50; stent retriever vs. combined: acOR = 1.13, 95% CI = 0.64 to 2.00; direct aspiration vs. combined: acOR = 1.19, 95% CI = 0.64 to 2.21). Direct aspiration thrombectomy was accompanied with more switches to another technique compared to the stent retriever (adjusted odds ratio (aOR) = 6.50, 95% CI = 2.52 to 16.8) or combined group (aOR = 4.67, 95% CI = 1.80 to 12.1) and with higher sICH rates compared to the combined technique (13% vs. 2.5%; aOR = 8.19, 95% CI = 1.49 to 45.1). Mortality, procedure time, and eTICI did not differ.

conclusionStent retriever, direct aspiration, or the combined thrombectomy technique as first-line approach showed no differences in clinical outcome in late-window stroke patients. Direct aspiration was accompanied with higher sICH rates and more switcher to another technique compared to the combined group.

Indexed as

Endovascular ProceduresThrombectomyAgedFemaleHumansMaleMiddle AgedStentsStrokeTreatment Outcomefirst-line techniqueintra-arterial thrombectomylate-windowStroke

Identifiers

PMID39075750
PMCPMC11590395

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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.