In 2015, endovascular treatment (EVT) was shown to be effective in improving functional outcome in patients with ischaemic stroke due to intracranial large vessel occlusion. A large proportion of treatment effect on functional outcome remains unexplained, suggesting FIV alone cannot be used as an early surrogate imaging marker of functional outcome.Follow-up infarct volume was related to functional outcome, but only explained a modest part of the effect of intervention on functional outcome.Endovascular treatment in acute ischaemic stroke patients prevents progression of follow-up infarct volume on non-contrast CT at 5– 7 days.The effect of EVT on FIV explains only part of the treatment effect on functional outcome. This implies that preventing FIV progression explains 14% (95% CI 0–34) of the beneficial effect of EVT on outcome. After adjustment for FIV the effect of intervention on functional outcome decreased but remained substantial (acOR 2.05, 95% CI 1.44–2.91). Smaller FIV was associated with better outcome (acOR per 10 ml 0.60, 95% CI 0.52–0.68). Patients in the intervention group had better functional outcomes (adjusted common odds ratio (acOR) 2.30 (95% CI 1.62–3.26) than controls and smaller FIV (median 53 vs. Of the 500 patients included in MR CLEAN, 60 died and four patients underwent hemicraniectomy before FIV was assessed, leaving 436 patients for analysis.
Explained effect was assessed by taking the ratio of the log odds ratios of treatment with and without adjustment for FIV.
We tested the causal pathway from intervention, via FIV to functional outcome with a mediation model, using linear and ordinal regression, adjusted for relevant baseline covariates, including stroke severity. Functional outcome was the score on the modified Rankin Scale at 3 months. MethodsįIV was assessed on non-contrast CT scan 5–7 days after stroke. We aimed to assess to what extent difference in FIV explains the effect of EVT on functional outcome in a randomised trial of EVT versus no EVT (MR CLEAN). 8.8.0.Exp.GERMAN.2.Mediator.V9.0./pztr4lx.The putative mechanism for the favourable effect of endovascular treatment (EVT) on functional outcome after acute ischaemic stroke is preventing follow-up infarct volume (FIV) progression. Matchware.Mediator.8.9.registered.and. Matchware.Mediator.9.No.registration.is.enjoy. 9.0.Flash!.Matchware’s.Mediator.is.a. on.Photoshop.Portable.5.0.2.MatchWare.A/S.
0 kommentar(er)
