2026-04-13T13:38:19Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1257102026-03-18T22:29:17Zcom_2072_1057col_2072_478916col_2072_478917

00925njm 22002777a 4500 dc Jovin, Tudor G. author Chamorro Sánchez, Ángel author Cobo, Erik author Miquel, Maria Angels de author Molina, Carlos A. author Rovira, Alex author San Román, Luis author Serena, Joaquín author Abilleira, Sònia author Ribó Jacobi, Marc author Millán, Mónica author Urra, Xabier author Cardona Portela, Pere author López Cancio, Elena author Tomasello, Alejandro author Castaño, Carlos author Blasco, Jordi author Aja, Lucía author Dorado, Laura author Quesada, Helena author Rubiera, Marta author Hernández Pérez, María author Goyal, Mayank author Demchuk, Andrew M. author Kummer, Rüdiger von author Gallofré, Miquel author Dávalos, Antoni author REVASCAT Trial Investigators author 2018-10-29T14:38:59Z 2018-10-29T14:38:59Z 2015-06-11 2018-07-24T12:30:06Z 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. Malalties cerebrovasculars Isquèmia cerebral Cerebrovascular disease Cerebral ischemia Thrombectomy within 8 hours after symptom onset in ischemic stroke