To access the full text documents, please follow this link: http://hdl.handle.net/2117/84030

Thrombectomy within 8 hours after symptom onset in ischemic stroke
Jovin, Tudor G.; Chamorro, Ángel; Cobo Valeri, Erik
Universitat Politècnica de Catalunya. Departament d'Estadística i Investigació Operativa; Universitat Politècnica de Catalunya. GRBIO - Grup de Recerca en Bioestadística i Bioinformàtica
BACKGROUND: We aimed to assess the safety and efficacy of thrombectomy for the treatment of stroke in a trial embedded within a population-based stroke reperfusion registry. METHODS: During a 2-year period at four centers in Catalonia, Spain, we randomly assigned 206 patients who could be treated within 8 hours after the onset of symptoms of acute ischemic stroke to receive either medical therapy (including intravenous alteplase when eligible) and endovascular therapy with the Solitaire stent retriever (thrombectomy group) or medical therapy alone (control group). All patients had confirmed proximal anterior circulation occlusion and the absence of a large infarct on neuroimaging. In all study patients, the use of alteplase either did not achieve revascularization or was contraindicated. The primary outcome was the severity of global disability at 90 days, as measured on the modified Rankin scale (ranging from 0 [no symptoms] to 6 [death]). Although the maximum planned sample size was 690, enrollment was halted early because of loss of equipoise after positive results for thrombectomy were reported from other similar trials. RESULTS: Thrombectomy reduced the severity of disability over the range of the modified Rankin scale (adjusted odds ratio for improvement of 1 point, 1.7; 95% confidence interval [CI], 1.05 to 2.8) and led to higher rates of functional independence (a score of 0 to 2) at 90 days (43.7% vs. 28.2%; adjusted odds ratio, 2.1; 95% CI, 1.1 to 4.0). At 90 days, the rates of symptomatic intracranial hemorrhage were 1.9% in both the thrombectomy group and the control group (P = 1.00), and rates of death were 18.4% and 15.5%, respectively (P = 0.60). Registry data indicated that only eight patients who met the eligibility criteria were treated outside the trial at participating hospitals. CONCLUSIONS: Among patients with anterior circulation stroke who could be treated within 8 hours after symptom onset, stent retriever thrombectomy reduced the severity of post-stroke disability and increased the rate of functional independence.
Peer Reviewed
Àrees temàtiques de la UPC::Ciències de la salut::Medicina::Neurologia
Cerebrovascular disease
ENDOVASCULAR THERAPY
ALTEPLASE
OUTCOMES
TRIALS
Embòlia i trombosi cerebral
info:eu-repo/semantics/publishedVersion
Article
         

Show full item record

Related documents

Other documents of the same author

Molina, Carlos A.; Chamorro, Ángel; Rovira, Alex; de Miquel, Maria Angeles; Serena Leal, Joaquín; Sanroman, Luis; Jovin, Tudor G.; Dávalos Errando, Antoni; Cobo Valeri, Erik
Urra, Xabier; Abilleira, Sonia; Dorado, Laura; Marc, Ribó; Cardona, Pere; Millán, Monica; Chamorro, Ángel; Molina, Carlos; Cobo Valeri, Erik; Dávalos Errando, Antoni; Jovin, Tudor G.; Gallofre, Miquel
López-Cancio, Elena; Salvat, Mercé; Cerda, Neus; Jimenez, Marta; Codas, Javier; Llull, Laura; Boned, Sara; Cano, Luis M.; Blanca, Lara; Molina, Carlos; Cobo Valeri, Erik; Dávalos Errando, Antoni; Jovin, Tudor G.; Serena Leal, Joaquín
Cobo Valeri, Erik; González Alastrué, José Antonio; Muñoz Gracia, María del Pilar; Dieguez, José Manuel; Piñeiro, Martiño
Quesada, Aurelio; Navarro, Xavier; Cobo Valeri, Erik; Adragao, Pedro; Ricci, Renato; Hadid, Claudio; Almendral, Jesús; Ortiz, Mercedes; Schwab, Joerg Otto; Janko, Sabine; Mischke, Karl; Arribas, Fernando; Wolpert, Christian
 

Coordination

 

Supporters