Patient-Relevant Deficits Dictate Endovascular Thrombectomy
Decision-Making in Patients with Low NIHSS Scores with
Medium-Vessel Occlusion Stroke

J 2021

Patient-Relevant Deficits Dictate Endovascular Thrombectomy Decision-Making in Patients with Low NIHSS Scores with Medium-Vessel Occlusion Stroke

MCDONOUGH, R., Petra CIMFLOVÁ, N. KASHANI, J. M. OSPEL, M. KAPPELHOF et. al.

Základní údaje

Originální název

Patient-Relevant Deficits Dictate Endovascular Thrombectomy Decision-Making in Patients with Low NIHSS Scores with Medium-Vessel Occlusion Stroke

Autoři

MCDONOUGH, R., Petra CIMFLOVÁ (203 Česká republika, domácí), N. KASHANI, J. M. OSPEL, M. KAPPELHOF, N. SINGH, A. SEHGAL, N. SAKAI, J. FIEHLER, M. CHEN a M. GOYAL (garant)

Vydání

American Journal of Neuroradiology, Denville, American Society of Neuroradiology, 2021, 0195-6108

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30224 Radiology, nuclear medicine and medical imaging

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 4.966

Kód RIV

RIV/00216224:14110/21:00124156

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.3174/ajnr.A7253

UT WoS

000687635300001

Klíčová slova anglicky

Endovascular Thrombectomy; Low NIHSS Scores; Medium-Vessel Occlusion Stroke

Štítky

14110119, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 15. 2. 2022 10:09, Mgr. Tereza Miškechová

Anotace

V originále

BACKGROUND AND PURPOSE: There is a paucity of evidence regarding the safety of endovascular treatment for patients with acute ischemic stroke due to primary medium-vessel occlusion. The aim of this study was to examine the willingness among stroke physicians to perform endovascular treatment in patients with mild-yet-disabling deficits due to medium-vessel occlusion. MATERIALS AND METHODS: In an international cross-sectional survey consisting of 7 primary medium-vessel occlusion case scenarios, participants were asked whether the presence of personally disabling deficits would influence their decision-making for endovascular treatment despite the patients having low NIHSS scores (<6). Decision rates were calculated on the basis of physician characteristics. Univariable logistic regression clustered by respondent and scenario identity was performed. RESULTS: Three hundred sixty-six participants from 44 countries provided 2562 answers to the 7 medium-vessel occlusion scenarios included in this study. In scenarios in which the deficit was relevant to the patient?s profession, 56.9% of respondents opted to perform immediate endovascular treatment compared with 41.0% when no information regarding the patient?s profession was provided (risk ratio = 1.39, P?100 endovascular treatments per year (risk ratio = 1.63; 95% CI, 1.22?2.17). CONCLUSIONS: The presence of a patient-relevant deficit in low-NIHSS acute ischemic stroke due to medium-vessel occlusion is an important factor for endovascular treatment decision-making. This may have relevance for the conduct and interpretation of low-NIHSS endovascular treatment in randomized trials.

Citovat

MCDONOUGH, R., Petra CIMFLOVÁ, N. KASHANI, J. M. OSPEL, M. KAPPELHOF, N. SINGH, A. SEHGAL, N. SAKAI, J. FIEHLER, M. CHEN a M. GOYAL. Patient-Relevant Deficits Dictate Endovascular Thrombectomy Decision-Making in Patients with Low NIHSS Scores with Medium-Vessel Occlusion Stroke. American Journal of Neuroradiology. Denville: American Society of Neuroradiology, 2021, roč. 42, č. 10, s. 1834-1838. ISSN 0195-6108. Dostupné z: https://dx.doi.org/10.3174/ajnr.A7253.

@article{1834311,
   author = {McDonough, R. and Cimflová, Petra and Kashani, N. and Ospel, J. M. and Kappelhof, M. and Singh, N. and Sehgal, A. and Sakai, N. and Fiehler, J. and Chen, M. and Goyal, M.},
   article_location = {Denville},
   article_number = {10},
   doi = {http://dx.doi.org/10.3174/ajnr.A7253},
   keywords = {Endovascular Thrombectomy; Low NIHSS Scores; Medium-Vessel Occlusion Stroke},
   language = {eng},
   issn = {0195-6108},
   journal = {American Journal of Neuroradiology},
   title = {Patient-Relevant Deficits Dictate Endovascular Thrombectomy Decision-Making in Patients with Low NIHSS Scores with Medium-Vessel Occlusion Stroke},
   url = {http://www.ajnr.org/content/42/10/1834},
   volume = {42},
   year = {2021}
}

TY  - JOUR
ID  - 1834311
AU  - McDonough, R. - Cimflová, Petra - Kashani, N. - Ospel, J. M. - Kappelhof, M. - Singh, N. - Sehgal, A. - Sakai, N. - Fiehler, J. - Chen, M. - Goyal, M.
PY  - 2021
TI  - Patient-Relevant Deficits Dictate Endovascular Thrombectomy Decision-Making in Patients with Low NIHSS Scores with Medium-Vessel Occlusion Stroke
JF  - American Journal of Neuroradiology
VL  - 42
IS  - 10
SP  - 1834-1838
EP  - 1834-1838
PB  - American Society of Neuroradiology
SN  - 01956108
KW  - Endovascular Thrombectomy
KW  - Low NIHSS Scores
KW  - Medium-Vessel Occlusion Stroke
UR  - http://www.ajnr.org/content/42/10/1834
N2  - BACKGROUND AND PURPOSE: There is a paucity of evidence regarding the safety of endovascular treatment for patients with acute ischemic stroke due to primary medium-vessel occlusion. The aim of this study was to examine the willingness among stroke physicians to perform endovascular treatment in patients with mild-yet-disabling deficits due to medium-vessel occlusion. MATERIALS AND METHODS: In an international cross-sectional survey consisting of 7 primary medium-vessel occlusion case scenarios, participants were asked whether the presence of personally disabling deficits would influence their decision-making for endovascular treatment despite the patients having low NIHSS scores (<6). Decision rates were calculated on the basis of physician characteristics. Univariable logistic regression clustered by respondent and scenario identity was performed. RESULTS: Three hundred sixty-six participants from 44 countries provided 2562 answers to the 7 medium-vessel occlusion scenarios included in this study. In scenarios in which the deficit was relevant to the patient?s profession, 56.9% of respondents opted to perform immediate endovascular treatment compared with 41.0% when no information regarding the patient?s profession was provided (risk ratio = 1.39, P?100 endovascular treatments per year (risk ratio = 1.63; 95% CI, 1.22?2.17). CONCLUSIONS: The presence of a patient-relevant deficit in low-NIHSS acute ischemic stroke due to medium-vessel occlusion is an important factor for endovascular treatment decision-making. This may have relevance for the conduct and interpretation of low-NIHSS endovascular treatment in randomized trials.
ER  -

MCDONOUGH, R., Petra CIMFLOVÁ, N. KASHANI, J. M. OSPEL, M. KAPPELHOF, N. SINGH, A. SEHGAL, N. SAKAI, J. FIEHLER, M. CHEN a M. GOYAL. Patient-Relevant Deficits Dictate Endovascular Thrombectomy Decision-Making in Patients with Low NIHSS Scores with Medium-Vessel Occlusion Stroke. \textit{American Journal of Neuroradiology}. Denville: American Society of Neuroradiology, 2021, roč.~42, č.~10, s.~1834-1838. ISSN~0195-6108. Dostupné z: https://dx.doi.org/10.3174/ajnr.A7253.

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