Evidence map›Paper›PMID 40330548›Full record

ArticleEClinicalMedicine2025

Interaction of brain imaging features and effects of intensive blood pressure lowering after endovascular treatment for acute ischaemic stroke: the pre-specified secondary analyses of ENCHANTED2/MT trial.

Xiaoxi Zhang, Xinwen Ren, Yongxin Zhang, Yongwei Zhang, Lei Zhang, Hongjian Shen, Zifu Li, Pengfei Xing, Ping Zhang, Weilong Hua and 22 more

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 3 papers.

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

NCT04140110 naterminatednot on this map

Second Enhanced Control of Hypertension and Thrombectomy Stroke Study (ENCHANTED2)

TypeinterventionalSponsorThe George Institute for Global Health, ChinaRan2020 to 2022Enrolled816ConditionsAcute Ischemic StrokeArmsIntensive BP lowering
NCT07527013 phase3not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Stratified Blood Pressure Management After Endovascular Treatment for Acute Ischemic Stroke (RESCUE-BP)

TypeinterventionalSponsorBeijing Tiantan HospitalRan2026 to 2028Enrolled544ConditionsEndovascular Therapy, Acute Ischaemic Stroke, Collateral Circulation, Blood Pressure ManagementArmsStratified Blood Pressure Management
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

32 authors.

Xiaoxi ZhangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Xinwen RenThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
Yongxin ZhangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Yongwei ZhangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Lei ZhangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Hongjian ShenNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Zifu LiNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Pengfei XingNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Ping ZhangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Weilong HuaNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Fang ShenNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Bing TianDepartment of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Wenhuo ChenDepartment of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.
Hongxing HanDepartment of Neurology, Linyi People's Hospital, Linyi, China.
Liyong ZhangDepartment of Neurosurgery, Liaocheng People's Hospital, Liaocheng, China.
Chenghua XuDepartment of Neurology, Taizhou First People's Hospital, Taizhou, China.
Tong LiDepartment of Neurology, The Second People's Hospital of Nanning, Nanning, China.
Yu GaoNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Yu ZhouNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Qiao ZuoNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Dongwei DaiNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Rui ZhaoNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Qiang LiNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Qinghai HuangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Yi XuNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Xiaoying ChenThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
Qiang LiThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
Lili SongInstitute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
Craig S AndersonInstitute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
Pengfei YangNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Jianmin LiuNeurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
ENCHANTED2/MT Collaboration

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The second Enhanced Control of Hypertension and Thrombectomy Stroke Study (ENCHANTED2/MT) was terminated early when the intensive blood pressure lowering to a systolic level of 120 mm Hg or lower, compared to 140-180 mm Hg, was harmful in patients who received successful endovascular therapy for acute ischaemic stroke due to large-vessel occlusion. We aimed to determine the interaction of key brain imaging features and the effect of treatment on clinical outcomes. Methods: ENCHANTED2/MT was a prospective, randomised, open-label, blinded-endpoint, controlled trial that aimed to assess the effectiveness of different intensities of blood pressure control on the functional independence in patients who had received successful endovascular therapy for acute ischaemic stroke from large-vessel occlusion at 44 hospitals in China between July 20, 2020 and March 7, 2022. In these pre-specified secondary analyses, neuroradiologists reviewed the baseline brain images of participants (computerised tomography [CT], CT with angiography [CTA] and digital subtraction angiography [DSA]) blind to treatment allocation, to determine the degree of cerebral infarction on the Alberta Stroke Program Early CT Score (ASPECTS), collateral status according to modified TAN score, and degree of reperfusion on the expanded Treatment In Cerebral Infarction (eTICI) scale. The primary outcome was functional independence, according to the distribution of scores on the modified Rankin scale (range 0 [no symptoms] to 6 [death]) at 90 days. Multivariable logistic regression analysis was done according to the modified intention-to-treat principle in all participants with available outcome data. ENCHANTED2/MT is registered with ClinicalTrials.gov, NCT04140110. Findings: Of 816 participants in the trial, in whom 407 were assigned to more intensive blood pressure lowering and 409 were assigned to less intensive blood pressure lowering treatment, there were 533, 372, and 757 participants with available data for ASPECTS, collateral flow, and eTICI analyses, respectively. Intensive blood pressure lowering was associated with worse functional independence in participants with complete reperfusion (eTICI 3: adjusted odds ratio [aOR] 1.51, 95% CI 1.14-2.02) but not in those with incomplete reperfusion (eTICI 2b/c: aOR 1.29, 95% CI 0.73-2.28), without significant interaction (p Interpretation: Our study indicates that collateral status may help identify patients at risk from intensive blood pressure lowering treatment to a systolic target of 120 mm Hg or lower, in patients undergoing endovascular therapy for acute ischaemic stroke from large-vessel occlusion. Funding: The Shanghai Hospital Development Center; National Health and Medical Research Council of Australia; Medical Research Foundation (MRF) of the UK; AstraZeneca; China Stroke Prevention; Shanghai Changhai Hospital, Science and Technology Commission of Shanghai Municipality; Takeda China; Hasten Biopharmaceutic; Genesis Medtech; Penumbra.

Indexed as

Acute ischaemic strokeBlood pressureCollateral statusEndovascular thrombectomyRandomised trial

Identifiers

PMID40330548
PMCPMC12051051

What OpenQuestion holds

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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.