Endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial”

Background. – Until recently, the benefits of endovascular treatment in stroke were not proven. Care trials have been designed to simultaneously offer yet-to-be validated interventions and verify treatment outcomes. Our aim was to implement a care trial for patients with acute ischemic stroke. Metho...

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Principais autores: Khoury, Naim N., Darsaut, Tim E., Ghostine, Jimmy, Deschaintre, Yan, Daneault, Nicole, Durocher, André, Lanthier, Sylvain, Poppe, Alexandre Y., Odier, Céline, Lebrun, Louise-Hélène, Guilbert, François, Gentric, Jean-Christophe, Batista, André Lima, Weill, Alain, Roy, Daniel, Bracard, Serge, Raymond, Jean
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Idioma:pt_BR
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acute stroke
endovascular treatment
thrombectomy
randomized clinical trial
Endereço do item:https://repositorio.ufrn.br/handle/123456789/52461
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spelling ri-123456789-524612023-05-17T16:19:43Z Endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial” Khoury, Naim N. Darsaut, Tim E. Ghostine, Jimmy Deschaintre, Yan Daneault, Nicole Durocher, André Lanthier, Sylvain Poppe, Alexandre Y. Odier, Céline Lebrun, Louise-Hélène Guilbert, François Gentric, Jean-Christophe Batista, André Lima Weill, Alain Roy, Daniel Bracard, Serge Raymond, Jean acute stroke endovascular treatment thrombectomy randomized clinical trial Background. – Until recently, the benefits of endovascular treatment in stroke were not proven. Care trials have been designed to simultaneously offer yet-to-be validated interventions and verify treatment outcomes. Our aim was to implement a care trial for patients with acute ischemic stroke. Methods. – The study was offered to all patients considered for endovascular management of acute ischemic stroke in one Canadian hospital. Inclusion criteria were broad: onset of symptoms ≤ 5 h or at any time in the presence of clinical-imaging mismatch and suspected or demonstrated proximal large vessel occlusion. Exclusion criteria were few: established infarction or hemorrhagic transforma tion of the target symptomatic territory and poor 3-month prognosis. The primary outcome was mRS ≤ 2 at 3 months. Patients were randomly allocated to standard care or standard care plus endovascular treatment. ClinicalTrials.gov: Identifier NCT02157532. Results. – Seventy-seven patients were recruited in 19 months (March 2013–October 2014) at a single center. Randomized allocation was interrupted when other trials showed the benefits of endovascular therapy. At 3 months, 20 of 40 patients (50.0%; 95% CI: 35%–65%) in the intervention group had reached the primary outcome, compared to 14 of 37 patients (37.8%; 95% CI: 24%–54%) in the control group (P = 0.36). Eleven patients in the intervention group died within 3 months compared to 9 patients in the standard care group. Conclusion. – A care trial was implemented to offer verifiable care to acute stroke patients. This approach offers a promising means to manage clinical dilemmas and guide uncertain practices. 2023-05-17T16:18:24Z 2023-05-17T16:18:24Z 2017-09 article KHOURY, Naim N.; DARSAUT, Tim E.; GHOSTINE, Jimmy; DESCHAINTRE, Yan; DANEAULT, Nicole; DUROCHER, André; LANTHIER, Sylvain; POPPE, Alexandre Y.; ODIER, Céline; LEBRUN, Louise-Hélène. Erratum to “Endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial⠽ Journal of Neuroradiol. 44 (2017) 198⠳202. Journal Of Neuroradiology, [S.L.], v. 44, n. 5, p. 351, set. 2017. Elsevier BV. DOI; http://dx.doi.org/10.1016/j.neurad.2017.05.005 https://repositorio.ufrn.br/handle/123456789/52461 10.1016/j.neurad.2017.01.126 pt_BR
institution Repositório Institucional
collection RI - UFRN
language pt_BR
topic acute stroke
endovascular treatment
thrombectomy
randomized clinical trial
spellingShingle acute stroke
endovascular treatment
thrombectomy
randomized clinical trial
Khoury, Naim N.
Darsaut, Tim E.
Ghostine, Jimmy
Deschaintre, Yan
Daneault, Nicole
Durocher, André
Lanthier, Sylvain
Poppe, Alexandre Y.
Odier, Céline
Lebrun, Louise-Hélène
Guilbert, François
Gentric, Jean-Christophe
Batista, André Lima
Weill, Alain
Roy, Daniel
Bracard, Serge
Raymond, Jean
Endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial”
description Background. – Until recently, the benefits of endovascular treatment in stroke were not proven. Care trials have been designed to simultaneously offer yet-to-be validated interventions and verify treatment outcomes. Our aim was to implement a care trial for patients with acute ischemic stroke. Methods. – The study was offered to all patients considered for endovascular management of acute ischemic stroke in one Canadian hospital. Inclusion criteria were broad: onset of symptoms ≤ 5 h or at any time in the presence of clinical-imaging mismatch and suspected or demonstrated proximal large vessel occlusion. Exclusion criteria were few: established infarction or hemorrhagic transforma tion of the target symptomatic territory and poor 3-month prognosis. The primary outcome was mRS ≤ 2 at 3 months. Patients were randomly allocated to standard care or standard care plus endovascular treatment. ClinicalTrials.gov: Identifier NCT02157532. Results. – Seventy-seven patients were recruited in 19 months (March 2013–October 2014) at a single center. Randomized allocation was interrupted when other trials showed the benefits of endovascular therapy. At 3 months, 20 of 40 patients (50.0%; 95% CI: 35%–65%) in the intervention group had reached the primary outcome, compared to 14 of 37 patients (37.8%; 95% CI: 24%–54%) in the control group (P = 0.36). Eleven patients in the intervention group died within 3 months compared to 9 patients in the standard care group. Conclusion. – A care trial was implemented to offer verifiable care to acute stroke patients. This approach offers a promising means to manage clinical dilemmas and guide uncertain practices.
format article
author Khoury, Naim N.
Darsaut, Tim E.
Ghostine, Jimmy
Deschaintre, Yan
Daneault, Nicole
Durocher, André
Lanthier, Sylvain
Poppe, Alexandre Y.
Odier, Céline
Lebrun, Louise-Hélène
Guilbert, François
Gentric, Jean-Christophe
Batista, André Lima
Weill, Alain
Roy, Daniel
Bracard, Serge
Raymond, Jean
author_facet Khoury, Naim N.
Darsaut, Tim E.
Ghostine, Jimmy
Deschaintre, Yan
Daneault, Nicole
Durocher, André
Lanthier, Sylvain
Poppe, Alexandre Y.
Odier, Céline
Lebrun, Louise-Hélène
Guilbert, François
Gentric, Jean-Christophe
Batista, André Lima
Weill, Alain
Roy, Daniel
Bracard, Serge
Raymond, Jean
author_sort Khoury, Naim N.
title Endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial”
title_short Endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial”
title_full Endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial”
title_fullStr Endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial”
title_full_unstemmed Endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial”
title_sort endovascular thrombectomy and medical therapy versus medical therapy alone in acute stroke: a randomized care trial”
publishDate 2023
url https://repositorio.ufrn.br/handle/123456789/52461
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