دورية أكاديمية
Endovascular Therapy after Intravenous t-PA versus t-PA Alone for Stroke
| العنوان: | Endovascular Therapy after Intravenous t-PA versus t-PA Alone for Stroke |
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| المؤلفون: | Broderick, JP, Palesch, YY, Demchuk, AM, Yeatts, SD, Khatri, P, Hill, MD, Jauch, EC, Jovin, TG, Yan, B, Silver, FL, von Kummer, R, Molina, CA, Demaerschalk, BM, Budzik, R, Clark, WM, Zaidat, OO, Malisch, TW, Goyal, M, Schonewille, WJ, Mazighi, M, Engelter, ST, Anderson, C, Spilker, J, Carrozzella, J, Ryckborst, KJ, Janis, LS, Martin, RH, Foster, LD, Tomsick, TA |
| بيانات النشر: | MASSACHUSETTS MEDICAL SOC |
| سنة النشر: | 2013 |
| المجموعة: | The University of Melbourne: Digital Repository |
| مصطلحات موضوعية: | Central Nervous System, Nervous System and Disorders |
| الوصف: | C1 - Journal Articles Refereed ; BACKGROUND: Endovascular therapy is increasingly used after the administration of intravenous tissue plasminogen activator (t-PA) for patients with moderate-to-severe acute ischemic stroke, but whether a combined approach is more effective than intravenous t-PA alone is uncertain. METHODS: We randomly assigned eligible patients who had received intravenous t-PA within 3 hours after symptom onset to receive additional endovascular therapy or intravenous t-PA alone, in a 2:1 ratio. The primary outcome measure was a modified Rankin scale score of 2 or less (indicating functional independence) at 90 days (scores range from 0 to 6, with higher scores indicating greater disability). RESULTS: The study was stopped early because of futility after 656 participants had undergone randomization (434 patients to endovascular therapy and 222 to intravenous t-PA alone). The proportion of participants with a modified Rankin score of 2 or less at 90 days did not differ significantly according to treatment (40.8% with endovascular therapy and 38.7% with intravenous t-PA; absolute adjusted difference, 1.5 percentage points; 95% confidence interval [CI], -6.1 to 9.1, with adjustment for the National Institutes of Health Stroke Scale [NIHSS] score [8-19, indicating moderately severe stroke, or ≥20, indicating severe stroke]), nor were there significant differences for the predefined subgroups of patients with an NIHSS score of 20 or higher (6.8 percentage points; 95% CI, -4.4 to 18.1) and those with a score of 19 or lower (-1.0 percentage point; 95% CI, -10.8 to 8.8). Findings in the endovascular-therapy and intravenous t-PA groups were similar for mortality at 90 days (19.1% and 21.6%, respectively; P=0.52) and the proportion of patients with symptomatic intracerebral hemorrhage within 30 hours after initiation of t-PA (6.2% and 5.9%, respectively; P=0.83). CONCLUSIONS: The trial showed similar safety outcomes and no significant difference in functional independence with endovascular therapy after ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0028-4793 1533-4406 |
| العلاقة: | http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000315669100005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=d4d813f4571fa7d6246bdc0dfeca3a1cTest; Broderick, J. P., Palesch, Y. Y., Demchuk, A. M., Yeatts, S. D., Khatri, P., Hill, M. D., Jauch, E. C., Jovin, T. G., Yan, B., Silver, F. L., von Kummer, R., Molina, C. A., Demaerschalk, B. M., Budzik, R., Clark, W. M., Zaidat, O. O., Malisch, T. W., Goyal, M., Schonewille, W. J. ,. Tomsick, T. A. (2013). Endovascular Therapy after Intravenous t-PA versus t-PA Alone for Stroke. NEW ENGLAND JOURNAL OF MEDICINE, 368 (10), pp.893-903. https://doi.org/10.1056/NEJMoa1214300Test.; http://hdl.handle.net/11343/33125Test |
| الإتاحة: | https://doi.org/10.1056/NEJMoa1214300Test http://hdl.handle.net/11343/33125Test http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000315669100005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=d4d813f4571fa7d6246bdc0dfeca3a1cTest |
| رقم الانضمام: | edsbas.6820A4E5 |
| قاعدة البيانات: | BASE |
| تدمد: | 00284793 15334406 |
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