Thrombectomy vs medical management in low NIHSS acute anterior circulation stroke.
Aged
Aged, 80 and over
Arterial Occlusive Diseases
/ therapy
Cerebral Arterial Diseases
/ therapy
Disease Progression
Endovascular Procedures
/ statistics & numerical data
Female
Fibrinolytic Agents
/ administration & dosage
Follow-Up Studies
Humans
Ischemic Stroke
/ drug therapy
Male
Middle Aged
Outcome Assessment, Health Care
/ statistics & numerical data
Registries
Severity of Illness Index
Thrombectomy
/ statistics & numerical data
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
15 12 2020
15 12 2020
Historique:
received:
24
04
2020
accepted:
12
08
2020
pubmed:
30
9
2020
medline:
26
1
2021
entrez:
29
9
2020
Statut:
ppublish
Résumé
To undertake an effectiveness and safety analysis of EVT in patients with LVO and NIH Stroke Scale (NIHSS) score ≤6 using datasets of multicenter and multinational nature. We pooled patients with anterior circulation occlusion from 3 prospective international cohorts. Patients were eligible if presentation occurred within 12 hours from last known well and baseline NIHSS ≤6. Primary outcome was modified Rankin Scale (mRS) score 0-1 at 90 days. Secondary outcomes included neurologic deterioration at 24 hours (change in NIHSS of ≥2 points), mRS 0-2 at 90 days, and 90-day all-cause mortality. We used propensity score matching to adjust for nonrandomized treatment allocation. Among 236 patients who fit inclusion criteria, 139 received EVT and 97 received medical management. Compared to medical management, the EVT group was younger (65 vs 72 years; EVT for LVO in patients with low NIHSS score was associated with increased risk of neurologic deterioration at 24 hours. However, both EVT and medical management resulted in similar proportions of excellent clinical outcomes at 90 days. This study provides Class III evidence that for patients with acute anterior circulation ischemic strokes and LVO with NIHSS < 6, EVT and medical management result in similar outcomes at 90 days.
Identifiants
pubmed: 32989100
pii: WNL.0000000000010955
doi: 10.1212/WNL.0000000000010955
pmc: PMC7836655
doi:
Substances chimiques
Fibrinolytic Agents
0
Types de publication
Comparative Study
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e3364-e3372Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 American Academy of Neurology.
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