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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Thrombectomy within 8 hours after symptom onset in ischemic stroke
Tudor G Jovin1, Angel Chamorro, Erik Cobo
1The authors' affiliations are listed in the Appendix.
The New England Journal of Medicine
|April 18, 2015
Summary
Mechanical thrombectomy significantly improves outcomes for acute ischemic stroke patients. This endovascular therapy reduces disability and increases functional independence within 8 hours of symptom onset.
Area of Science:
- Neurology
- Interventional Cardiology
- Public Health
Background:
- Assessing the safety and efficacy of thrombectomy for stroke treatment.
- Trial embedded within a population-based stroke reperfusion registry.
Purpose of the Study:
- Evaluate thrombectomy's effectiveness in acute ischemic stroke patients.
- Compare endovascular therapy with medical management.
Main Methods:
- Randomized trial of 206 patients within 8 hours of stroke onset.
- Thrombectomy group received medical therapy plus Solitaire stent retriever; control group received medical therapy alone.
- Primary outcome: modified Rankin scale at 90 days.
Main Results:
- Thrombectomy reduced disability severity (OR, 1.7) and increased functional independence (OR, 2.1).
- Rates of symptomatic intracranial hemorrhage and death were similar between groups.
- 43.7% of thrombectomy patients achieved functional independence vs. 28.2% in the control group.
Conclusions:
- Stent retriever thrombectomy is effective for anterior circulation stroke within 8 hours.
- Reduced post-stroke disability and increased functional independence were observed.
- Thrombectomy is a safe and effective treatment option for selected stroke patients.
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