•
PROBE two-arm superiority trial of 316 patients with acute ischemic disabling stroke, NIHSS > 5, capable of being randomized up to 12 hours after onset.
•
CT/CTA, NECT and CTA (multiphase): door to imaging <25 minutes
•
Small infarct core (ASPECTS = 6-10 or CTP)
•
Occluded proximal artery in anterior circulation, MCA -M1 or 2 or more M2, moderate to good collaterals(filling of 50% of the pial MCA on CTA)
•
1:1 randomization of 58 patients who received IV rtPA within 4.5 hours
•
Receive guideline-based care alone or guideline-based care plus endovascular treatment with the use of available thrombectomy devices. The use of retrievable stents and suction through a balloon guide catheter during thrombus retrieval was also recommended.
•
The primary outcome was the odds ratio that the intervention would lead to lower scores on the mRS at 90 days (shift analysis).
PROBE two-arm superiority trial of 316 patients with acute ischemic disabling stroke, NIHSS > 5, capable of being randomized up to 12 hours after onset.
•
CT/CTA, NECT and CTA (multiphase): door to imaging <25 minutes
•
Small infarct core (ASPECTS = 6-10 or CTP)
•
Occluded proximal artery in anterior circulation, MCA -M1 or 2 or more M2, moderate to good collaterals(filling of 50% of the pial MCA on CTA)
•
1:1 randomization of 58 patients who received IV rtPA within 4.5 hours
•
Receive guideline-based care alone or guideline-based care plus endovascular treatment with the use of available thrombectomy devices. The use of retrievable stents and suction through a balloon guide catheter during thrombus retrieval was also recommended.
•
The primary outcome was the odds ratio that the intervention would lead to lower scores on the mRS at 90 days (shift analysis).
Results:
•
Interim analysis after the O'Brien Fleming stopping boundary was crossed.
•
Primary Outcome: The adjusted odds ratio (indicating the odds of improvement of 1 point on the mRS) was 3.1 (95% CI, 2.0 to 4.7) favoring endovascular intervention.
•
The difference in proportion of patients with a mRS of 0-2 at 90 days was 53% in favor of the intervention group versus 23.7% in the control group (p<0.001).
•
Retrievable stents were used in 86.1% who underwent an endovascular procedure.
•
TICI 2b/3 recanalization was observed in 72.4% in the endovascular group.
•
The number randomized after 6 hours was too small to reach any conclusions regarding intervention beyond 6 hours.
•
Interim analysis after the O'Brien Fleming stopping boundary was crossed.
•
Primary Outcome: The adjusted odds ratio (indicating the odds of improvement of 1 point on the mRS) was 3.1 (95% CI, 2.0 to 4.7) favoring endovascular intervention.
•
The difference in proportion of patients with a mRS of 0-2 at 90 days was 53% in favor of the intervention group versus 23.7% in the control group (p<0.001).
•
Retrievable stents were used in 86.1% who underwent an endovascular procedure.
•
TICI 2b/3 recanalization was observed in 72.4% in the endovascular group.
•
The number randomized after 6 hours was too small to reach any conclusions regarding intervention beyond 6 hours.
COMMENT
used cta AND ct-p AND ASPECTS SCORE
No comments:
Post a Comment