Evidence map›Paper›PMID 38757713›Full record

Trial reportEuropean stroke journal2024

Safety and clinical outcomes of endovascular therapy versus medical management in late presentation of large ischemic stroke.

Adnan Mujanovic, Daniel Strbian, Jelle Demeestere, João Pedro Marto, Volker Puetz, Raul G Nogueira, Mohamad Abdalkader, Simon Nagel, Jean Raymond, Marc Ribo and 50 more

Registry-linked trialAbstract readClinical TrialComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European stroke journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04096248 (Non-Contrast CT vs CTP or MRI Selection vs Medical Management in Late Presentation of Large Vessel Occlusion Stroke, 6-24 Hours. A Multicenter Retrospective Study), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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.

NCT04096248 completednot on this map

Non-Contrast CT vs CTP or MRI Selection vs Medical Management in Late Presentation of Large Vessel Occlusion Stroke, 6-24 Hours. A Multicenter Retrospective Study

TypeobservationalSponsorBoston Medical CenterRan2020 to 2022Enrolled2,790ConditionsStroke, Cardiovascular
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Observational
  4. Observational
  5. Article
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

60 authors.

Adnan MujanovicDiagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0002-6839-7134
Daniel StrbianNeurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.ORCID 0000-0001-9095-2344
Jelle DemeestereNeurology, UZ Leuven, Leuven, Belgium.ORCID 0000-0001-8186-0237
João Pedro MartoNeurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.ORCID 0000-0003-2277-5950
Volker PuetzNeurology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Raul G NogueiraNeurology, University of Pittsburgh Medical Center, Pittsburgh, USA.
Mohamad AbdalkaderNeurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, USA.
Simon NagelNeurology, Klinikum Ludwigshafen, Ludwigshafen, Germany.
Jean RaymondInterventional Neuroradiology, Centre Hospitalier de l'Universite de Montreal, Radiology, Montreal, Canada.
Marc RiboNeurology, Hospital Vall d'Hebron, Barcelona, Spain.
Patrik MichelNeurology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Shinichi YoshimuraNeurosurgery, Hyogo Medical University, Japan.
Osama O ZaidatNeuroscience and Stroke Program, Bon Secours Mercy Health St. Vincent Hospital, Toledo, USA.
Simon WinzerNeurology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Santiago Ortega-GutierrezNeurology, University of Iowa, Iowa City, USA.
Sunil A ShethNeurology, UTHealth McGovern Medical School, Neurology, Houston, USA.
James E SieglerNeurology, University of Chicago, Chicago, USA.
Anne DusartNeurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
Diogo C HaussenNeurology, Grady Memorial Hospital, Atlanta, USA.
Hilde HenonNeurology, Centre Hospitalier Universitaire de Lille, Lille, France.
Bettina L SerrallachDiagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland.
Mahmoud H MohammadenNeurology, Grady Memorial Hospital, Atlanta, USA.
Markus A MöhlenbruchRadiology, Heidelberg University Hospital, Heidelberg, Germany.ORCID 0000-0002-5075-704X
Marta Olive-GadeaNeurology, Hospital Vall d'Hebron, Barcelona, Spain.
Ajit S PuriDivision of Interventional Neuroradiology, University of Massachusetts Memorial Medical Center, Worcester, USA.
Nobuyuki SakaiNeurosurgery, Seijinkai Shimizu Hospital, Kyoto, Japan.ORCID 0000-0002-3289-1210
Piers KleinNeurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, USA.ORCID 0000-0001-7468-137X
Liisa TomppoNeurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.ORCID 0000-0002-9369-5846
Francois CaparrosNeurology, Centre Hospitalier Universitaire de Lille, Lille, France.
João Nuno RamosNeuroradiology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Occidental, Lisbon, Portugal.ORCID 0000-0001-9678-3422
Mouhammad JumaaNeurology, University of Toledo, Toledo, USA.
Syed ZaidiNeurology, University of Toledo, Toledo, USA.
Tomas DobrockyDiagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland.
Nicolas Martinez-MajanderNeurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.ORCID 0000-0001-8489-7051
Stefania NannoniClinical Neurosciences, University of Cambridge, Cambridge, UK.
Flavio BellanteNeurology, Hôpital Civil Marie Curie, Charleroi, Belgium.ORCID 0000-0002-8718-9250
Aaron Rodriguez-CalienesNeurology, University of Iowa, Iowa City, USA.
Sergio Salazar-MarioniNeurology, UTHealth McGovern Medical School, Neurology, Houston, USA.ORCID 0000-0002-2722-7542
Pekka VirtanenRadiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.ORCID 0000-0002-9547-4940
Daniel Po KaiserDresden Neurovascular Center, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Rita VenturaNeurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Jessica JesserRadiology, Heidelberg University Hospital, Heidelberg, Germany.ORCID 0000-0002-1236-8828
Alicia C CastonguayNeurology, University of Toledo, Toledo, USA.
Muhammad M QureshiNeurosurgery, University of Pittsburgh Medical Center, Pittsburgh, USA.
Hesham E MasoudNeurology, State University of New York, Syracuse, USA.
Milagros Galecio-CastilloNeurology, University of Iowa, Iowa City, USA.
Manuel RequenaNeurology, Hospital Vall d'Hebron, Barcelona, Spain.ORCID 0000-0002-5671-6484
Riikka LauhaRadiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Wei HuNeurology, The First Affiliated Hospital of USTC, China.
Eugene LinNeuroscience and Stroke Program, Bon Secours Mercy Health St. Vincent Hospital, Toledo, USA.
Zhongrong MiaoInterventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China.
Daniel RoyInterventional Neuroradiology, Centre Hospitalier de l'Universite de Montreal, Radiology, Montreal, Canada.
Hiroshi YamagamiDivision of Stroke Prevention and Treatment, University of Tsukuba, Tsukuba, Japan.
David J SeiffgeNeurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0003-3890-3849
Davide StramboNeurology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Peter A RinglebNeurology, Heidelberg University Hospital, Heidelberg, Germany.
Robin LemmensNeurology, UZ Leuven, Leuven, Belgium.
Urs FischerNeurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Thanh N NguyenRadiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, USA.ORCID 0000-0002-2810-1685
Johannes KaesmacherDiagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe benefit of endovascular therapy (EVT) among stroke patients with large ischemic core (ASPECTS 0-5) in the extended time window outside of trial settings remains unclear. We analyzed the effect of EVT among these stroke patients in real-world settings. PATIENTS AND

methodsThe CT for Late Endovascular Reperfusion (CLEAR) study recruited patients from 66 centers in 10 countries between 01/2014 and 05/2022. The extended time-window was defined as 6-24 h from last-seen-well to treatment. The primary outcome was shift of the 3-month modified Rankin scale (mRS) score. Safety outcomes included symptomatic intracranial hemorrhage (sICH) and mortality. Outcomes were analyzed with ordinal and logistic regressions.

resultsAmong 5098 screened patients, 2451 were included in the analysis (median age 73, 55% women). Of patients with ASPECTS 0-5 (

conclusionIn the extended time window, patients with ASPECTS 0-5 may have preserved relative treatment benefit of EVT compared to patients with ASPECTS 6-10. These findings are in line with recent trials showing benefit of EVT among real-world patients with large ischemic core in the extended time window. TRIAL REGISTRATION NUMBER: clinicaltrials.gov; Unique identifier: NCT04096248.

Indexed as

Endovascular ProceduresIschemic StrokeAgedAged, 80 and overBrain IschemiaFemaleHumansIntracranial HemorrhagesMaleMiddle AgedTime FactorsTime-to-TreatmentTreatment Outcomebest medical treatmentEndovascular therapyextended time-windowlarge ischemic coremechanical thrombectomy

Identifiers

PMID38757713
PMCPMC11569454

What Socratic holds

Textmetadata
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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 Socratic graph.