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Stroke: Large-scale cerebral ischemia, thrombus removal treatment effect or poor

 Last Update: 2021-09-19
 Source: Internet
 Author: User

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At present, 4 randomized controlled trials (RCTs; TENSION, TESLA, IN EXTREMIS-LASTE, SELECT2) are studying the potential benefits of endovascular therapy (EVT) in patients with extensive ischemic infarction signs at the time of admission

Blood vessel

However, due to the lower expected effect, a larger sample size than previous RCTs is needed to prove the substantive therapeutic effect of this subgroup

In the past the thrombus excised important related RCT, the patient is to assess the therapeutic ASPECTS≤5 The heterogeneity imaging program comprises a computer tomography (CT) and magnetic resonance imaging, including the selection appears

Thrombotic stroke

Although CT imaging represents the most frequently used real-world model for the detection and treatment of large vessel occlusive stroke

Therefore, the currently available random and retrospective evidence may not represent the real-world situation of EVT decision-making based on CT in patients with low ASPECTS

And assume that EVT is more advantageous than BMT

The patients were selected from the German Stroke Registry and 3 tertiary stroke centers

After a 1:1 pairing, a total of 248 patients were compared by treatment group

They found that in the EVT group, 27.

The mortality rate (43.

Compared with the best medical treatment, patients with complete recanalization (modified Cerebral Infarction Thrombolysis Scale score of 3) and recanalization attempts ≤2 benefit the most (modified Rankin Scale score ≤3: 42.

In daily clinical practice, EVT may not be beneficial for patients with anterior circulation stroke with a low Alberta Stroke Program Early CT Score based on CT selection, and it may be associated with an increased risk of bleeding and death.

Original Source:

Thrombectomy in Extensive Stroke May Not Be Beneficial and Is Associated With Increased Risk for Hemorrhage.
Stroke

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