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.

Basic information

Original name

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

Authors

MCDONOUGH, R., Petra CIMFLOVÁ (203 Czech Republic, belonging to the institution), N. KASHANI, J. M. OSPEL, M. KAPPELHOF, N. SINGH, A. SEHGAL, N. SAKAI, J. FIEHLER, M. CHEN and M. GOYAL (guarantor)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30224 Radiology, nuclear medicine and medical imaging

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 4.966

RIV identification code

RIV/00216224:14110/21:00124156

Organization unit

Faculty of Medicine

DOI

UT WoS

000687635300001

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 15/2/2022 10:09, Mgr. Tereza Miškechová

Abstract

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.