Endovascular Therapy Versus Medical Management for Large Ischemic Infarct: 1-Year Outcomes of the ANGEL-ASPECT Trial

作者：Xiaochuan Huo, Dapeng Sun, Thanh N. Nguyen, Gaoting Ma, Yuesong Pan, Xin Tong, Guangxiong Yuan, Hongxing Han, Wenhuo Chen, Ming Wei, Jiangang Zhang, Zhiming Zhou, Xiaoxi Yao, Weigen Song, Xueli Cai, Guangxian Nan, Di Li, Alvin Yi-Chou Wang, Wentong Ling, Chuwei Cai, Changming Wen, En Wang, Liyong Zhang, Changchun Jiang, Geng Liao, Xiaohui Chen, Tianxiao Li, Shudong Liu, Jinglun Li, Yaxuan Sun, Na Xu, Zongen Gao, Dongsheng Ju, Cunfeng Song, Feng Zhou, Qing Shi, Jun Luo, Yan Liu, Zaiyu Guo, Hongbo Zheng, Linzhi Dai, Junfeng Zhao, Xiaokun Geng, Yufeng Tang, Congguo Yin, Hua Yang, Xuelei Zhang, Shuo Li, Mohamad Abdalkader, Feng Gao, Ning Ma, Dapeng Mo, Zeguang Ren, Liping Liu, Yongjun Wang, Zhongrong Miao, on behalf of the ANGEL-ASPECT Investigators · 发表于：Stroke · 年份：2025 · DOI：10.1161/strokeaha.124.050086 · 被引用次数：7 · 研究领域：Acute Ischemic Stroke Management、Peripheral Artery Disease Management、Cerebrovascular and Carotid Artery Diseases

BACKGROUND: Several trials have shown the benefit and safety of endovascular therapy (EVT) compared with medical management (MM) of patients with a large ischemic core in the 90-day follow-up. However, the 1-year outcome comparison between EVT and MM in Asian patients with a large ischemic core has not been investigated. Our aim was to evaluate the 1-year outcomes of patients in the ANGEL-ASPECT trial (Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients with a Large Infarct Core). METHODS: In this phase 3, randomized, open-label, blinded end point assessment trial, patients with anterior circulation large vessel occlusion and an Alberta Stroke Program Early CT Score of 3 to 5 or an infarct core volume of 70 to 100 mL were enrolled across 46 hospitals in China. Patients were randomly assigned 1:1 to EVT or MM. The 90-day outcomes were previously reported. We report a prespecified analysis of the ANGEL-ASPECT trial, with 1-year functional outcome as the primary outcome in this study. The primary outcome was the shift of the modified Rankin Scale (mRS) score (range, 0-6, with a higher score reflecting greater disability) to better outcomes at 1-year. The secondary outcomes included functional independence (mRS score, 0-2), independent ambulation (mRS score, 0-3), and mortality. This trial is registered with https://www.clinicaltrials.gov (Unique identifier: NCT04551664). RESULTS: =0.04). Functional independence and independent ambulation were highe...