RT Journal Article
SR Electronic
T1 Association between stroke subtypes and outcomes of endovascular therapy: a post-hoc analysis of the ANGEL-ASPECT Trial
JF Stroke and Vascular Neurology
JO Stroke Vasc Neurol
FD BMJ Publishing Group Ltd
SP svn-2024-003115
DO 10.1136/svn-2024-003115
A1 Lu, Da
A1 ­, Raynald
A1 Sun, Dapeng
A1 Zheng, Na
A1 Zhang, Bohao
A1 Luo, Leilei
A1 Wang, Sifei
A1 Pan, Sihu
A1 Dou, Yuchao
A1 Wang, Mengxing
A1 Pan, Yuesong
A1 Huo, Xiaochuan
A1 Miao, Zhongrong
A1 Wei, Ming
YR 2024
UL http://svn.bmj.com/content/early/2024/09/17/svn-2024-003115.abstract
AB Objectives Our study aims to examine the value of endovascular therapy (EVT) and its comparison to medical management (MM) in ischaemic stroke patients accompanied by large artery atherosclerosis (LAA) and non-LAAMethods modified Rankin scale score (mRS) was evaluated at 90 days post the stroke attack and was considered as the primary outcome. Other outcomes measured in this study included score changes of 0–2 and 0–3 on the mRS. The occurrence of symptomatic intracranial haemorrhage at 24 hours after EVT was also measured as a safety endpoint. Logistic regression analysis was used to determine the associations.Results In the LAA group, no significant difference in mRS at 90-day (median IQR 3 (2–5) vs 4 (3–4), 95% CI 0.53 to 2.00, p=0.924), mRS 0–2 and mRS 0–3 was observed between EVT and MM groups. However, in the non-LAA group, patients who underwent EVT had lower 90-day mRS scores (4 (2–5) vs 4 (3–5), generalised OR 1.47, 95% CI 1.14 to 1.88, p<0.001). No interaction effect on the primary outcomes between treatment options and aetiology. More intracranial haemorrhage events within 48 hours were identified in the EVT group for both LAA and non-LAA cohorts (LAA: 40.98% vs 9.62%, relative risk (RR) 4.26, 95% CI 1.76 to 10.34, p<0.001; non-LAA, 52.07% vs 19.65%, RR 2.65, 95% CI 1.90 to 3.70, respectively).Conclusions For large infarcts, EVT may be more effective than MM for patients with non-LAA aetiology, but not for those with LAA stroke. As no interaction effect was found, the benefit of EVT compared with MM did not vary by stroke subtypes.Data are available on reasonable request.