دورية أكاديمية
Thrombectomy within 8 hours after symptom onset in ischemic stroke
| العنوان: | Thrombectomy within 8 hours after symptom onset in ischemic stroke |
|---|---|
| المؤلفون: | Jovin, Tudor G., Chamorro Sánchez, Ángel, Cobo, Erik, Miquel, Maria Angeles de, Molina, Carlos A., Rovira, Alex, San Román, Luis, Serena, Joaquín, Abilleira, Sonia, Ribó Panosa, Marc, Millán, Mònica, Urra, Xabier, Cardona-Portela, Pere, López Cancio, Elena, Tomasello, Alejandro, Castaño, Carlos, Blasco, Jordi, Aja, Lucía, Dorado, Laura, Quesada, Helena, Rubiera, Marta, Hernández Pérez, María, Goyal, Mayank, Demchuk, Andrew M., Kummer, Rüdiger von, Gallofré, Miquel, Dávalos, Antoni, REVASCAT Trial Investigators |
| المصدر: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
| بيانات النشر: | Massachusetts Medical Society |
| سنة النشر: | 2015 |
| المجموعة: | Dipòsit Digital de la Universitat de Barcelona |
| مصطلحات موضوعية: | Malalties cerebrovasculars, Isquèmia cerebral, Cerebrovascular disease, Cerebral ischemia |
| الوصف: | 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 ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | 12 p.; application/pdf |
| اللغة: | English |
| العلاقة: | Reproducció del document publicat a: https://doi.org/10.1056/NEJMoa1503780Test; New England Journal of Medicine, 2015, vol. 372, num. 24, p. 2296-2306; https://doi.org/10.1056/NEJMoa1503780Test; http://hdl.handle.net/2445/125710Test |
| الإتاحة: | https://doi.org/10.1056/NEJMoa1503780Test http://hdl.handle.net/2445/125710Test |
| حقوق: | (c) Massachusetts Medical Society, 2015 ; info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.AF195051 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |