Effect of stroke etiology on endovascular thrombectomy with or without intravenous alteplase: a subgroup analysis of DIRECT-MT.
Autor: | Pengfei Xing, Xiaoxi Zhang, Hongjian Shen, Fang Shen, Lei Zhang, Zifu Li, Yongxin Zhang, Bo Hong, Huaizhang Shi, Hongxing Han, Xiaofei Ye, Yongwei Zhang, Pengfei Yang, Jianmin Liu |
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Předmět: |
STROKE
INTRAVENOUS therapy CONFIDENCE intervals BLOOD vessels MULTIPLE regression analysis CEREBRAL infarction INTRACRANIAL hemorrhage CEREBRAL revascularization NIH Stroke Scale MANN Whitney U Test THERAPEUTIC embolization TREATMENT effectiveness ATHEROSCLEROSIS RISK assessment THROMBECTOMY DESCRIPTIVE statistics CHI-squared test QUALITY of life QUESTIONNAIRES ENDOVASCULAR surgery COMBINED modality therapy ODDS ratio COMPUTED tomography DATA analysis software TISSUE plasminogen activator CEREBRAL arteriosclerosis |
Zdroj: | Journal of NeuroInterventional Surgery; Dec2022, Vol. 14 Issue 12, p1200-1206, 7p |
Abstrakt: | Background Stroke etiology might influence the clinical outcomes in patients with large vessel occlusion receiving endovascular treatment (EVT) with or without thrombolysis. Objective To examine whether stroke etiology resulted in different efficacy and safety in patients treated with EVT-alone or EVT preceded by intravenous alteplase (combined therapy). Methods We assessed the efficacy and safety of treatment strategy based on prespecified stroke etiology, cardioembolism (CE), large-artery atherosclerosis (LAA), and undetermined cause (UC) for patients enrolled in the DIRECT-MT trial. The primary outcome was the modified Rankin Scale (mRS) score at 90 days. Multivariate ordinal logistic regression analysis was used to calculate the adjusted common OR for a shift of better mRS score for EVT-alone versus combined therapy. A term was entered to test for interaction. Results In this study, 656 patients were grouped into three prespecified stroke etiologic subgroups. The adjusted common ORs for improvement in the 90-day ordinal mRS score with EVT-alone were 1.2 (95% CI 0.8 to 1.8) for CE, 1.6 (95% CI 0.8 to 3.3) for LAA, and 0.8 (95% CI 0.5 to 1.3) for UC. Compared with CE, EVT- alone was more likely to result in an mRS score of 0-1 (p |
Databáze: | Complementary Index |
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