Noncontrast CT sufficient for identifying patients of acute ischaemic stroke likely to benefit from endovascular thrombectomy

Findings

From July 17, 2018, to Feb 21, 2023, 253 patients were randomly assigned, with 125 patients assigned to endovascular thrombectomy and 128 to medical treatment alone. The trial was stopped early for efficacy after the first pre-planned interim analysis. At 90 days, endovascular thrombectomy was associated with a shift in the distribution of scores on the modified Rankin Scale towards better outcome (adjusted common OR 2·58 [95% CI 1·60–4·15]; p=0·0001) and with lower mortality (hazard ratio 0·67 [95% CI 0·46–0·98]; p=0·038). Symptomatic intracranial haemorrhage occurred in seven (6%) patients with thrombectomy and in six (5%) with medical treatment alone.

Endovascular thrombectomy was associated with improved functional outcome and lower mortality in patients with acute ischaemic stroke from large vessel occlusion with established large infarct in a setting using non-contrast CT as the predominant imaging modality for patient selection.

Reference:

Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomised trial. Prof Martin Bendszus, Prof Jens Fiehler, Fabien Subtil, Susanne Bonekamp, Anne Hege Aamodt, Prof Blanca Fuentes, et al. Show all authors. Published:October 11, 2023DOI:https://doi.org/10.1016/S0140-6736(23)02032-9

Keywords:

Noncontrast CT, sufficient, for, identifying, patients, acute, ischaemic, stroke, likely, benefit, from, endovascular, thrombectomy, lancet, Prof Martin Bendszus, Prof Jens Fiehler, Fabien Subtil, Susanne Bonekamp, Anne Hege Aamodt, Prof Blanca Fuentes