Evidence map›Paper›PMID 37615093›Full record

Trial reportStroke2023

Long-Term Stroke Risk in Patients With New Ischemic Brain Lesions on MRI After Carotid Revascularization.

Simone J A Donners, Marjolijn L Rots, Raechel J Toorop, Aad van der Lugt, Leo H Bonati, Gert J de Borst

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.3field-weighted citation impact, top 11% of its field
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, 9 citations in OpenAlex.

  1. Article
  2. Article
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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

6 authors at 5 institutions in 3 countries.

Simone J A DonnersDepartment of Vascular Surgery, University Medical Center Utrecht, the Netherlands (S.J.A.D., R.J.T., G.J.d.B.).ORCID 0000-0002-7461-000X
Marjolijn L RotsDepartment of General Surgery, Jeroen Bosch Hospital, Den Bosch, the Netherlands (M.L.R.).
Raechel J TooropDepartment of Vascular Surgery, University Medical Center Utrecht, the Netherlands (S.J.A.D., R.J.T., G.J.d.B.).
Aad van der LugtDepartment of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands (A.v.d.L.).ORCID 0000-0002-6159-2228
Leo H BonatiDepartment of Neurology and Stroke Center, University Hospital Basel, Switzerland (L.H.B.).ORCID 0000-0003-1163-8133
Gert J de BorstDepartment of Vascular Surgery, University Medical Center Utrecht, the Netherlands (S.J.A.D., R.J.T., G.J.d.B.).ORCID 0000-0002-1389-4141
University Medical Center Utrecht · NLErasmus MC · NLJeroen Bosch Ziekenhuis · NLUniversity Hospital of Basel · CHUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCarotid artery revascularization can result in new ischemic brain lesions on diffusion-weighted magnetic resonance imaging. This study aimed to investigate the relationship between periprocedural ischemic diffusion-weighted imaging (DWI) lesions after carotid artery revascularization and recurrent long-term cerebrovascular events.

methodsA secondary observational prospective cohort analysis of existing clinical trial data was performed on 162 patients with symptomatic carotid stenosis that were previously randomized to carotid artery stenting or carotid endarterectomy in the ICSS (International Carotid Stenting Study) and included in the magnetic resonance imaging substudy. Magnetic resonance imagings were performed 1 to 7 days before and 1 to 3 days after treatment. The primary composite clinical outcome was the time to any stroke or transient ischemic attack during follow-up. Patients with new diffusion-weighted imaging (DWI) lesions on posttreatment magnetic resonance imaging scan (DWI+) were compared with patients without new lesions (DWI-).

resultsThe median time of follow-up was 8.6 years (interquartile range, 5.0-12.5). Kaplan-Meier cumulative incidence for the primary outcome after 12.5-year follow-up was 35.3% (SE, 8.9%) in DWI+ patients and 31.1% (SE, 5.6%) in DWI- patients. Uni- and multivariable regression analyses did not show significant differences (hazard ratio, 1.50 [95% CI, 0.76-2.94] and hazard ratio, 1.30 [95% CI, 0.10-1.02], respectively). Higher event rate of the primary outcome in DWI+ patients in the overall cohort was mainly caused by events in the carotid artery stenting group.

conclusionsBased on our outcome analysis within the ICSS magnetic resonance imaging substudy, DWI lesions following carotid revascularization did not seem to have a relationship with long-term stroke risk. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: ISRCTN 25337470.

Indexed as

Brain IschemiaCarotid StenosisEndarterectomy, CarotidStrokeBrainCarotid ArteriesDiffusion Magnetic Resonance ImagingHumansMagnetic Resonance ImagingProspective StudiesRisk FactorsStentsTreatment Outcomecarotid endarterectomycarotid stenosisdiffusion-weighted imaginglesionstroke

Identifiers

PMID37615093
PMCPMC10519293
OpenAlexW4386116390

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.