Evidence map›Paper›PMID 41656636›Full record

ArticleJournal of stroke2026

Does the Benefit of Thrombectomy in Large Strokes Depend on Perfusion-Diffusion Mismatch? A Large Stroke Therapy Evaluation Trial Post Hoc Analysis.

Adrien Ter Schiphorst, Caroline Arquizan, Guillaume Turc, Julien Labreuche, Bertrand Lapergue, David S Liebeskind, Hilde Henon, Nasreddine Nouri, Jean-François Albucher, Christophe Cognard and 21 more

Abstract read
In one paragraph

Article in Journal of stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

31 authors.

Adrien Ter SchiphorstDepartment of Neurology, CHRU Gui de Chauliac, Montpellier, France.
Caroline ArquizanDepartment of Neurology, CHRU Gui de Chauliac, Montpellier, France.
Guillaume TurcUniversité Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France.
Julien LabreucheDepartment of Biostatistics, Centre Hospitalier Universitaire (CHU) Lille, Lille, France.
Bertrand LapergueDepartment of Neurology, Foch Hospital, Versailles Saint-Quentin en Yvelines University, Suresnes, France.
David S LiebeskindDepartment of Neurology, UCLA Comprehensive Stroke Center, University of California, Los Angeles, CA, USA.
Hilde HenonDepartment of Neurology, Centre Hospitalier Universitaire (CHU) Lille, Lille, France.
Nasreddine NouriDepartment of Neuroradiology, Centre Hospitalier Universitaire (CHU) Lille, Lille, France.
Jean-François AlbucherDepartment of Neurology, Hôpital Pierre Paul Riquet, Toulouse, France.
Christophe CognardToulouse Clinical Investigations Centers 1436, Toulouse, France.
Gaultier MarnatDepartment of Neuroradiology, Hôpital Pellegrin, Bordeaux, France.
Igor SibonDepartment of Neurology, Hôpital Pellegrin, Bordeaux, France.
Benjamin GoryDepartment of Diagnostic and Therapeutic Neuroradiology, Université de Lorraine, CHRU-Nancy, Nancy, France.
Sébastien RichardDepartment of Neurology, Hôpital Central, Nancy, France.
Olivier NaggaraUniversité Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France.
Mariam AnnanDepartment of Neurology, Hôpital Bretonneau, Tours, France.
Grégoire BoulouisDepartment of Neuroradiology, Hôpital Bretonneau, Tours, France.
Eker F OmerDepartment of Neuroradiology, Hospices Civils de Lyon, Groupement Hospitalier Est Hôpital Pierre Wertheimer, Lyon, France.
Tae-Hee ChoDepartment of Neurology, Hospices Civils de Lyon, Groupement Hospitalier Est Hôpital Pierre Wertheimer, Lyon, France.
Federico Di MariaDepartment of Neuroradiology, Foch Hospital, Versailles Saint-Quentin en Yvelines University, Suresnes, France.
Romain BourcierDepartment of Neuroradiology, Nantes Université, CHU Nantes, Nantes, France.
Benoit GuillonDepartment of Neurology, Hôpital G.R. Laennec CHU Nantes, Nantes, France.
Michael ObadiaDepartment of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
Michel PiotinDepartment of Interventionnal Neuroradiology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
Anna FerrierDepartment of Neurology, CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, France.
Emmanuel ChabertDepartment of Neuroradiology, CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, France.
Mònica MillánDepartment of Neurology, Hospital Germans Trias i Pujol, Badalona, Spain.
Liesjet van DokkumDepartment of Neuroradiology, CHRU Gui de Chauliac, Montpellier, France.
Tudor G JovinDepartment of Neurology, Cooper University Hospital, Cooper Medical School at Rowan University, Camden, NJ, USA.
Emmanuelle Le BarsDepartment of Neuroradiology, CHRU Gui de Chauliac, Montpellier, France.
Vincent CostalatInstitut de génomique fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France.

Funding

Balt ExtrusionCerenovusMedtronicMicroVentionMontpellier University HospitalStryker Neurovascular
6 · The paper itself

Abstract

background and purposeWhether perfusion-diffusion mismatch modifies treatment effect of mechanical thrombectomy (MT) for large strokes is poorly known. To address this question, we conducted a post hoc secondary analysis of the Large Stroke Therapy Evaluation (LASTE) randomized controlled trial (RCT).

methodsThe LASTE RCT compared MT plus best medical treatment (BMT) to BMT alone in patients with large infarct (Alberta Stroke Program Early CT Score 0-5) in the 0-7-hour timewindow. This secondary analysis was restricted to patients with available baseline MR perfusionweighted imaging. We investigated the potential heterogeneity of MT treatment according to the presence of perfusion-diffusion mismatch, defined as a mismatch ratio ≥1.2, calculated as the time-to-maximum >6 seconds cerebral volume divided by ischemic core volume. The primary outcome was better functional outcome (favorable shift in the distribution of modified Rankin Scale [mRS] at 90 days, analyzed using generalized odds ratio [GenOR]).

resultsA total of 102/324 patients were included, among whom 55 (54%) had a perfusiondiffusion mismatch. No significant treatment effect heterogeneity by diffusion-perfusion mismatch was observed for the primary outcome (GenOR for better functional outcome: 1.70 [95% confidence interval, CI, 0.95 to 3.05] and 1.04 [95% CI, 0.57 to 1.87] in patients with and without mismatch, respectively; ratio of GenORs: 1.63 [95% CI, 0.71 to 3.74]; P for heterogeneity=0.24) or for the secondary efficacy and safety outcomes.

conclusionsOur study found no evidence of heterogeneity of treatment effect with respect to benefit or safety in patients with unrestricted infarct size at baseline treated with MT by presence of perfusion-diffusion mismatch. An individual participant-data meta-analysis of RCT is needed for definitive conclusions.

Indexed as

Brain infarctionClinical trialPerfusion imagingStrokeThrombectomy

Identifiers

PMID41656636
PMCPMC12883886

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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.