دورية أكاديمية
Association of Endovascular Thrombectomy vs Medical Management With Functional and Safety Outcomes in Patients Treated Beyond 24 Hours of Last Known Well: The SELECT Late Study
| العنوان: | Association of Endovascular Thrombectomy vs Medical Management With Functional and Safety Outcomes in Patients Treated Beyond 24 Hours of Last Known Well: The SELECT Late Study |
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| المؤلفون: | Sarraj, Amrou, Kleinig, Timothy J, Hassan, Ameer E, Portela, Pere Cardona, Ortega-Gutierrez, Santiago, Abraham, Michael G, Manning, Nathan W, Siegler, James E, Goyal, Nitin, Maali, Laith, Blackburn, Spiros, Wu, Teddy Y, Blasco, Jordi, Renú, Arturu, Sangha, Navdeep S, Arenillas, Juan F, McCullough-Hicks, Margy E, Wallace, Adam, Gibson, Daniel, Pujara, Deep K, Shaker, Faris, de Lera Alfonso, Mercedes, Olivé-Gadea, Marta, Farooqui, Mudassir, Vivanco Suarez, Juan S, Iezzi, Zachary, Khalife, Jane, Lechtenberg, Colleen G, Qadri, Syed K, Moussa, Rami B, Abdulrazzak, Mohammad A, Almaghrabi, Tareq S, Mir, Osman, Beharry, James, Krishnaiah, Balaji, Miller, Megan, Khalil, Najwa, Sharma, Gagan J, Katsanos, Aristeidis H, Fadhil, Ali, Duncan, Kelsey R, Hu, Yin, Martin-Schild, Sheryl B, Tsivgoulis, Georgios K, Cordato, Dennis, Furlan, Anthony, Churilov, Leonid, Mitchell, Peter J, Arthur, Adam S, Parsons, Mark W, Grotta, James C, Sitton, Clark W, Ribo, Marc, Albers, Gregory W, Campbell, Bruce C V |
| المصدر: | Journal Articles |
| بيانات النشر: | DigitalCommons@TMC |
| سنة النشر: | 2023 |
| المجموعة: | Houston Academy of Medicine-Texas Medical Center (HAM-TMC): DigitalCommons@The Texas Medical Center |
| مصطلحات موضوعية: | Humans, Female, Aged, Retrospective Studies, Endovascular Procedures, Stroke, Thrombectomy, Intracranial Hemorrhages, Treatment Outcome, Brain Ischemia, Critical Care, Diseases, Hematology, Medical Specialties, Medicine and Health Sciences, Neurology, Patient Safety, Public Health |
| الوصف: | IMPORTANCE: The role of endovascular thrombectomy is uncertain for patients presenting beyond 24 hours of the time they were last known well. OBJECTIVE: To evaluate functional and safety outcomes for endovascular thrombectomy (EVT) vs medical management in patients with large-vessel occlusion beyond 24 hours of last known well. DESIGN, SETTING, AND PARTICIPANTS: This retrospective observational cohort study enrolled patients between July 2012 and December 2021 at 17 centers across the United States, Spain, Australia, and New Zealand. Eligible patients had occlusions in the internal carotid artery or middle cerebral artery (M1 or M2 segment) and were treated with EVT or medical management beyond 24 hours of last known well. INTERVENTIONS: Endovascular thrombectomy or medical management (control). MAIN OUTCOMES AND MEASURES: Primary outcome was functional independence (modified Rankin Scale score 0-2). Mortality and symptomatic intracranial hemorrhage (sICH) were safety outcomes. Propensity score (PS)-weighted multivariable logistic regression analyses were adjusted for prespecified clinical characteristics, perfusion parameters, and/or Alberta Stroke Program Early CT Score (ASPECTS) and were repeated in subsequent 1:1 PS-matched cohorts. RESULTS: Of 301 patients (median [IQR] age, 69 years [59-81]; 149 female), 185 patients (61%) received EVT and 116 (39%) received medical management. In adjusted analyses, EVT was associated with better functional independence (38% vs control, 10%; inverse probability treatment weighting adjusted odds ratio [IPTW aOR], 4.56; 95% CI, 2.28-9.09; P < .001) despite increased odds of sICH (10.1% for EVT vs 1.7% for control; IPTW aOR, 10.65; 95% CI, 2.19-51.69; P = .003). This association persisted after PS-based matching on (1) clinical characteristics and ASPECTS (EVT, 35%, vs control, 19%; aOR, 3.14; 95% CI, 1.02-9.72; P = .047); (2) clinical characteristics and perfusion parameters (EVT, 35%, vs control, 17%; aOR, 4.17; 95% CI, 1.15-15.17; P = .03); and (3) ... |
| نوع الوثيقة: | text |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| العلاقة: | https://digitalcommons.library.tmc.edu/uthmed_docs/1153Test; https://digitalcommons.library.tmc.edu/context/uthmed_docs/article/2129/viewcontent/Association_of_Endovascular_Thrombectomy_vs_Medical_Management_With_Functional_and_Safety_Outcomes_in_Patients_Treated_Beyond_24_Hours_of_Last_Known_Well___PMC.pdfTest |
| الإتاحة: | https://digitalcommons.library.tmc.edu/uthmed_docs/1153Test https://digitalcommons.library.tmc.edu/context/uthmed_docs/article/2129/viewcontent/Association_of_Endovascular_Thrombectomy_vs_Medical_Management_With_Functional_and_Safety_Outcomes_in_Patients_Treated_Beyond_24_Hours_of_Last_Known_Well___PMC.pdfTest |
| رقم الانضمام: | edsbas.ADCB2D29 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |