| Improvements in recanalization with modern stroke therapy: a review of prospective ischemic stroke trials during the last two decades. | |
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MedLine Citation:
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PMID: 23042748 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: A number of recent trials evaluating intra-arterial therapies for acute ischemic stroke have been completed. We present a review of prospective acute ischemic stroke trials reported in a peer-reviewed forum during the last 20 years to provide insight into the general direction of this rapidly evolving field. METHODS: Prospective trials evaluating acute stroke intra-arterial therapies since 1999 were included, with the National Institute of Neurological Disorders and Stroke rtPA trial published in 1995 as a baseline comparator. Patient presenting factors and outcome data were analyzed based on year of publication and best-fit lines and linear regression analyses were generated. RESULTS: Thirteen prospective trials were included. Regression analyses demonstrated no appreciable change in the median NIH Stroke Scale score of subjects at the time of enrollment since 1995 (p=0.44) and no appreciable improvements in good outcome based on a modified Rankin score of 0-2 at 90 days (p=0.66) or mortality at 90 days (p=0.55). A significant increase in time from onset of symptoms to treatment among enrolled patients was noted from 1995 to 2012 (p=0.03). In addition, a significant improvement in recanalization/reperfusion was noted over the last two decades (p=0.02). CONCLUSIONS: This review of prospective acute ischemic stroke trials since 1999 indicates a substantial improvement in revascularization in the setting of a significant increase in time to therapy onset, but no appreciable change in good functional outcome. |
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Authors:
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Kyle M Fargen; Philip M Meyers; Pooja Khatri; J Mocco |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-6 |
Journal Detail:
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Title: Journal of neurointerventional surgery Volume: - ISSN: 1759-8486 ISO Abbreviation: J Neurointerv Surg Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101517079 Medline TA: J Neurointerv Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Neurosurgery, University of Florida, Gainesville, Florida, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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