Effect of Imaging Selection Paradigms on Endovascular Thrombectomy Outcomes in Patients With Acute Ischemic Stroke

作者：Jian Miao, Hongfei Sang, Fengli Li, Jeffrey L. Saver, Bo Lei, Jinglun Li, Raul G. Nogueira, Bo Song, Shudong Liu, Thanh N. Nguyen, Zhenglong Jin, Hongliang Zeng, Changming Wen, Guangxiong Yuan, Weilin Kong, Weidong Luo, Shuai Liu, Dongjing Xie, Jiacheng Huang, Chang Liu, Jie Yang, Jinrong Hu, Jiaxing Song, Chengsong Yue, Linyu Li, Yan Tian, Xiao Zhang, Dan Feng, Yani Gao, Huiying Fu, Wenjie Zi, Qingwu Yang, Zhongming Qiu, Shaojun Wang · 发表于：Stroke · 年份：2023 · DOI：10.1161/strokeaha.122.042203 · 被引用次数：29 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Intracerebral and Subarachnoid Hemorrhage Research

Background: The effect of imaging selection paradigms on endovascular thrombectomy outcomes in patients with acute ischemic stroke with large vessel occlusion remains uncertain. The study aimed to assess the effect of basic imaging (noncontrast computed tomography with or without computed tomographic angiography) versus advanced imaging (magnetic resonance imaging or computed tomography perfusion) on clinical outcomes following thrombectomy in patients with stroke with large vessel occlusion in the early and extended windows using a pooled analysis of patient-level data from 2 pivotal randomized clinical trials done in China. Methods: This post hoc analysis used data from 1182 patients included in 2 multicenter, randomized controlled trials in China that evaluated adjunct therapies to endovascular treatment for acute ischemic stroke (Direct Endovascular Treatment for Large Artery Anterior Circulation Stroke performed from May 20, 2018, through May 2, 2020, and Intravenous Tirofiban Before Endovascular Treatment in Stroke from October 10, 2018, through October 31, 2021). Patients with occlusion of the intracranial internal carotid artery or proximal middle cerebral artery (M1/M2 segments) were categorized according to baseline imaging modality (basic versus advanced) as well as treatment time window (early, 0–6 hours versus extended, 6–24 hours from last known well to puncture). The primary outcome was the proportion of patients with functional independence (modified Rankin Sc...