Effectiveness and safety of EVT in patients with acute LVO and low NIHSS
There is much uncertainty in endovascular treatment (EVT) decisions in patients with acute large vessel occlusion (LVO) and mild neurological deficits. From a prospective, nationwide stroke registry, all patients with LVO and baseline NIHSS <6 presenting within 24 h from the time last known well...
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| Published in | Frontiers in neurology Vol. 13; p. 955725 |
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| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Switzerland
Frontiers Media S.A
05.08.2022
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| Online Access | Get full text |
| ISSN | 1664-2295 1664-2295 |
| DOI | 10.3389/fneur.2022.955725 |
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| Abstract | There is much uncertainty in endovascular treatment (EVT) decisions in patients with acute large vessel occlusion (LVO) and mild neurological deficits.
From a prospective, nationwide stroke registry, all patients with LVO and baseline NIHSS <6 presenting within 24 h from the time last known well (LKW) were included. Early neurological deterioration (END) developed before EVT was prospectively collected as an increasing total NIHSS score ≥2 or any worsening of the NIHSS consciousness or motor subscores during hospitalization not related to EVT. Significant hemorrhage was defined as PH2 hemorrhagic transformation or hemorrhage at a remote site. The modified Rankin Scale (mRS) was prospectively collected at 3 months.
Among 1,083 patients, 149 (14%) patients received EVT after a median of 5.9 [3.6-12.3] h after LKW. In propensity score-matched analyses, EVT was not associated with mRS 0-1 (matched OR 0.99 [0.63-1.54]) but increased the risk of a significant hemorrhage (matched OR, 4.51 [1.59-12.80]). Extraneous END occurred in 207 (19%) patients after a median of 24.5 h [IQR, 13.5-41.9 h] after LKW (incidence rate, 1.41 [95% CI, 1.23-1.62] per 100 person-hours). END unrelated to EVT showed a tendency to modify the effectiveness of EVT (P-for-interaction, 0.08), which decreased the odds of having mRS 0-1 in mild LVO patients without END (adjusted OR, 0.63 [0.40-0.99]).
The use of EVT in patients with acute LVO and low NIHSS scores may require the assessment of individual risks of early deterioration, hemorrhagic complications and expected benefit. |
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| AbstractList | Background and purposeThere is much uncertainty in endovascular treatment (EVT) decisions in patients with acute large vessel occlusion (LVO) and mild neurological deficits.MethodsFrom a prospective, nationwide stroke registry, all patients with LVO and baseline NIHSS <6 presenting within 24 h from the time last known well (LKW) were included. Early neurological deterioration (END) developed before EVT was prospectively collected as an increasing total NIHSS score ≥2 or any worsening of the NIHSS consciousness or motor subscores during hospitalization not related to EVT. Significant hemorrhage was defined as PH2 hemorrhagic transformation or hemorrhage at a remote site. The modified Rankin Scale (mRS) was prospectively collected at 3 months.ResultsAmong 1,083 patients, 149 (14%) patients received EVT after a median of 5.9 [3.6–12.3] h after LKW. In propensity score-matched analyses, EVT was not associated with mRS 0-1 (matched OR 0.99 [0.63–1.54]) but increased the risk of a significant hemorrhage (matched OR, 4.51 [1.59–12.80]). Extraneous END occurred in 207 (19%) patients after a median of 24.5 h [IQR, 13.5–41.9 h] after LKW (incidence rate, 1.41 [95% CI, 1.23–1.62] per 100 person-hours). END unrelated to EVT showed a tendency to modify the effectiveness of EVT (P-for-interaction, 0.08), which decreased the odds of having mRS 0–1 in mild LVO patients without END (adjusted OR, 0.63 [0.40–0.99]).ConclusionsThe use of EVT in patients with acute LVO and low NIHSS scores may require the assessment of individual risks of early deterioration, hemorrhagic complications and expected benefit. There is much uncertainty in endovascular treatment (EVT) decisions in patients with acute large vessel occlusion (LVO) and mild neurological deficits. From a prospective, nationwide stroke registry, all patients with LVO and baseline NIHSS <6 presenting within 24 h from the time last known well (LKW) were included. Early neurological deterioration (END) developed before EVT was prospectively collected as an increasing total NIHSS score ≥2 or any worsening of the NIHSS consciousness or motor subscores during hospitalization not related to EVT. Significant hemorrhage was defined as PH2 hemorrhagic transformation or hemorrhage at a remote site. The modified Rankin Scale (mRS) was prospectively collected at 3 months. Among 1,083 patients, 149 (14%) patients received EVT after a median of 5.9 [3.6-12.3] h after LKW. In propensity score-matched analyses, EVT was not associated with mRS 0-1 (matched OR 0.99 [0.63-1.54]) but increased the risk of a significant hemorrhage (matched OR, 4.51 [1.59-12.80]). Extraneous END occurred in 207 (19%) patients after a median of 24.5 h [IQR, 13.5-41.9 h] after LKW (incidence rate, 1.41 [95% CI, 1.23-1.62] per 100 person-hours). END unrelated to EVT showed a tendency to modify the effectiveness of EVT (P-for-interaction, 0.08), which decreased the odds of having mRS 0-1 in mild LVO patients without END (adjusted OR, 0.63 [0.40-0.99]). The use of EVT in patients with acute LVO and low NIHSS scores may require the assessment of individual risks of early deterioration, hemorrhagic complications and expected benefit. There is much uncertainty in endovascular treatment (EVT) decisions in patients with acute large vessel occlusion (LVO) and mild neurological deficits.Background and purposeThere is much uncertainty in endovascular treatment (EVT) decisions in patients with acute large vessel occlusion (LVO) and mild neurological deficits.From a prospective, nationwide stroke registry, all patients with LVO and baseline NIHSS <6 presenting within 24 h from the time last known well (LKW) were included. Early neurological deterioration (END) developed before EVT was prospectively collected as an increasing total NIHSS score ≥2 or any worsening of the NIHSS consciousness or motor subscores during hospitalization not related to EVT. Significant hemorrhage was defined as PH2 hemorrhagic transformation or hemorrhage at a remote site. The modified Rankin Scale (mRS) was prospectively collected at 3 months.MethodsFrom a prospective, nationwide stroke registry, all patients with LVO and baseline NIHSS <6 presenting within 24 h from the time last known well (LKW) were included. Early neurological deterioration (END) developed before EVT was prospectively collected as an increasing total NIHSS score ≥2 or any worsening of the NIHSS consciousness or motor subscores during hospitalization not related to EVT. Significant hemorrhage was defined as PH2 hemorrhagic transformation or hemorrhage at a remote site. The modified Rankin Scale (mRS) was prospectively collected at 3 months.Among 1,083 patients, 149 (14%) patients received EVT after a median of 5.9 [3.6-12.3] h after LKW. In propensity score-matched analyses, EVT was not associated with mRS 0-1 (matched OR 0.99 [0.63-1.54]) but increased the risk of a significant hemorrhage (matched OR, 4.51 [1.59-12.80]). Extraneous END occurred in 207 (19%) patients after a median of 24.5 h [IQR, 13.5-41.9 h] after LKW (incidence rate, 1.41 [95% CI, 1.23-1.62] per 100 person-hours). END unrelated to EVT showed a tendency to modify the effectiveness of EVT (P-for-interaction, 0.08), which decreased the odds of having mRS 0-1 in mild LVO patients without END (adjusted OR, 0.63 [0.40-0.99]).ResultsAmong 1,083 patients, 149 (14%) patients received EVT after a median of 5.9 [3.6-12.3] h after LKW. In propensity score-matched analyses, EVT was not associated with mRS 0-1 (matched OR 0.99 [0.63-1.54]) but increased the risk of a significant hemorrhage (matched OR, 4.51 [1.59-12.80]). Extraneous END occurred in 207 (19%) patients after a median of 24.5 h [IQR, 13.5-41.9 h] after LKW (incidence rate, 1.41 [95% CI, 1.23-1.62] per 100 person-hours). END unrelated to EVT showed a tendency to modify the effectiveness of EVT (P-for-interaction, 0.08), which decreased the odds of having mRS 0-1 in mild LVO patients without END (adjusted OR, 0.63 [0.40-0.99]).The use of EVT in patients with acute LVO and low NIHSS scores may require the assessment of individual risks of early deterioration, hemorrhagic complications and expected benefit.ConclusionsThe use of EVT in patients with acute LVO and low NIHSS scores may require the assessment of individual risks of early deterioration, hemorrhagic complications and expected benefit. |
| Author | Lee, Jun Hong, Keun-Sik Yu, Kyung-Ho Lee, Byung-Chul Bae, Hee-Joon Kim, Chulho Park, Sang-Soon Park, Jong-Moo Menon, Bijoy K. Lee, Soo Joo Yum, Kyu Sun Choi, Kang-Ho Kim, Beom Joon Almekhlafi, Mohammed A. Kim, Jae Guk Kang, Kyusik Cho, Yong-Jin Kwon, Jee-Hyun Hong, Jeong-Ho Lee, Sang-Hwa Demchuk, Andrew Park, Hong-Kyun Kim, Bum Joon Kim, Joon-Tae Shin, Dong-Ick Kim, Wook-Joo Kim, Chi Kyung Jeong, Jin-Heon Han, Moon-Ku Lee, Juneyoung Han, Jung Hoon Lee, Keon-Joo Choi, Jay Chol Kang, Jihoon Kim, Jun Yup Kim, Dong-Eog Park, Hyungjong Sohn, Sung-Il Kim, Joong-Goo Yoo, Joonsang Park, Tai Hwan Oh, Mi-Sun Cha, Jae-Kwan Kim, Dae-Hyun Lee, Kyung Bok Baik, Sung Hyun Ryu, Wi-Sun |
| AuthorAffiliation | 9 Department of Radiology, Seoul National University Bundang Hospital , Seongnam-si , South Korea 22 Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital , Chuncheon-si , South Korea 6 Department of Neurology, Eulji University Hospital , Daejeon , South Korea 12 Department of Neurology, Dong-A University Hospital , Busan , South Korea 15 Department of Neurology, Yeungnam University Medical Center , Daegu , South Korea 21 Department of Neurology, Chungbuk National University Hospital , Cheongju-si , South Korea 7 Department of Neurology, Chonnam National University Hospital , Gwangju , South Korea 13 Department of Neurology, Seoul Medical Center , Seoul , South Korea 5 Department of Neurology, Asan Medical Center , Seoul , South Korea 16 Department of Neurology, Inje University Ilsan Paik Hospital , Goyang-si , South Korea 8 Department of Neurology, Keimyung University Dongsan Medical Center , Daegu , South Korea 4 Department of Neurology, Korea University Guro Hospital , Seo |
| AuthorAffiliation_xml | – name: 16 Department of Neurology, Inje University Ilsan Paik Hospital , Goyang-si , South Korea – name: 22 Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital , Chuncheon-si , South Korea – name: 14 Department of Neurology, Soonchunhyang University Hospital , Seoul , South Korea – name: 3 Department of Neurology, Yongin Severance Hospital , Yongin-si , South Korea – name: 21 Department of Neurology, Chungbuk National University Hospital , Cheongju-si , South Korea – name: 6 Department of Neurology, Eulji University Hospital , Daejeon , South Korea – name: 19 Department of Neurology, Jeju National University Hospital , Jeju , South Korea – name: 2 Calgary Stroke Program, Department of Clinical Neuroscience, Radiology and Community Health Sciences, University of Calgary , Calgary, AB , Canada – name: 18 Department of Neurology, Dongguk University Ilsan Hospital , Goyang-si , South Korea – name: 9 Department of Radiology, Seoul National University Bundang Hospital , Seongnam-si , South Korea – name: 13 Department of Neurology, Seoul Medical Center , Seoul , South Korea – name: 8 Department of Neurology, Keimyung University Dongsan Medical Center , Daegu , South Korea – name: 11 Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine , Seoul , South Korea – name: 12 Department of Neurology, Dong-A University Hospital , Busan , South Korea – name: 7 Department of Neurology, Chonnam National University Hospital , Gwangju , South Korea – name: 15 Department of Neurology, Yeungnam University Medical Center , Daegu , South Korea – name: 20 Department of Neurology, Ulsan University Hospital , Ulsan , South Korea – name: 4 Department of Neurology, Korea University Guro Hospital , Seoul , South Korea – name: 23 Department of Biostatistics, Korea University , Seoul , South Korea – name: 1 Department of Neurology and Cerebrovascular Center, Seoul National University College of Medicine, Seoul National University Bundang Hospital , Seongnam-si , South Korea – name: 17 Department of Neurology, Hallym University Sacred Heart Hospital , Anyang-si , South Korea – name: 5 Department of Neurology, Asan Medical Center , Seoul , South Korea – name: 10 Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine , Uijeongbu-si , South Korea |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35989920$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1136/neurintsurg-2020-016583 10.1186/s12883-019-1372-9 10.1002/(SICI)1097-0258(19970730)16:14<1645::AID-SIM596>3.0.CO;2-G 10.1038/jcbfm.2013.77 10.1001/jamaneurol.2020.2804 10.5853/jos.2020.01466 10.5853/jos.2015.17.1.38 10.18637/jss.v011.i10 10.1161/STROKEAHA.119.025426 10.5853/jos.2015.01655 10.1161/strokeaha.119.028562 10.1001/jamaneurol.2019.3112 10.1136/neurintsurg-2016-012633 10.5853/jos.2021.02446 10.1001/jamaneurol.2021.2025 10.1136/neurintsurg-2017-013243 10.1161/01.STR.24.1.35 10.1016/S0140-6736(16)00163-X 10.1212/WNL.0000000000010603 10.1037/gpr0000123 10.1371/journal.pone.0070996 10.5853/jos.2014.16.3.161 10.1161/STROKEAHA.118.022114 10.1161/STROKEAHA.119.027011 10.1001/jamaneurol.2020.3362 10.1161/STROKEAHA.120.030912 10.1177/2396987317746003 10.1161/STR.0000000000000158 10.1001/jamaneurol.2014.4354 10.1161/STROKEAHA.115.010049 10.1161/STROKEAHA.120.032950 10.1161/STROKEAHA.118.021106 10.1212/WNL.0000000000010955 10.1177/2396987319832140 10.1186/s12874-017-0338-0 10.1161/STROKEAHA.117.019228 10.5853/jos.2021.01375 10.1007/s00415-020-09744-0 10.1007/s10072-021-05771-5 |
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| Copyright | Copyright © 2022 Kim, Menon, Yoo, Han, Kim, Kim, Kim, Kim, Park, Baik, Han, Kang, Kim, Lee, Park, Kang, Lee, Cha, Kim, Jeong, Park, Park, Lee, Lee, Hong, Cho, Park, Lee, Yu, Oh, Kim, Ryu, Choi, Choi, Kim, Kwon, Kim, Shin, Yum, Sohn, Hong, Kim, Lee, Lee, Almekhlafi, Demchuk and Bae. Copyright © 2022 Kim, Menon, Yoo, Han, Kim, Kim, Kim, Kim, Park, Baik, Han, Kang, Kim, Lee, Park, Kang, Lee, Cha, Kim, Jeong, Park, Park, Lee, Lee, Hong, Cho, Park, Lee, Yu, Oh, Kim, Ryu, Choi, Choi, Kim, Kwon, Kim, Shin, Yum, Sohn, Hong, Kim, Lee, Lee, Almekhlafi, Demchuk and Bae. 2022 Kim, Menon, Yoo, Han, Kim, Kim, Kim, Kim, Park, Baik, Han, Kang, Kim, Lee, Park, Kang, Lee, Cha, Kim, Jeong, Park, Park, Lee, Lee, Hong, Cho, Park, Lee, Yu, Oh, Kim, Ryu, Choi, Choi, Kim, Kwon, Kim, Shin, Yum, Sohn, Hong, Kim, Lee, Lee, Almekhlafi, Demchuk and Bae |
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| Keywords | low NIHSS score multicenter registry endovascular recanalization CRCS-K mild stroke early neurological deterioration |
| Language | English |
| License | Copyright © 2022 Kim, Menon, Yoo, Han, Kim, Kim, Kim, Kim, Park, Baik, Han, Kang, Kim, Lee, Park, Kang, Lee, Cha, Kim, Jeong, Park, Park, Lee, Lee, Hong, Cho, Park, Lee, Yu, Oh, Kim, Ryu, Choi, Choi, Kim, Kwon, Kim, Shin, Yum, Sohn, Hong, Kim, Lee, Lee, Almekhlafi, Demchuk and Bae. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| References | Hong (B18) 2016; 18 Park (B22) 2020; 95 Alexandre (B9) 2022; 43 Zeileis (B24) 2004; 11 McCarthy (B28) 2021; 13 Kim (B29) 2013; 8 Goyal (B1) 2016; 387 Shang (B11) 2019; 19 Seners (B13) 2021; 78 Powers (B19) 2018; 49 Kummer Rv (B23) 2015; 46 Haussen (B8) 2018; 10 Heldner (B10) 2020; 267 Goyal (B4) 2020; 77 Ospel (B35) 2021; 52 Sarraj (B34) 2021; 52 Noorian (B2) 2018; 49 Saito (B6) 2020; 51 Turc (B31) 2019; 4 Kim (B33) 2020; 78 Sarraj (B32) 2018; 49 Nagel (B5) 2018; 49 Lee (B39) 2022; 24 Mazya (B14) 2018; 3 Adams (B20) 1993; 24 Jeong (B38) 2019; 50 Nguyen (B25) 2017; 17 Campbell (B37) 2013; 33 Pan (B26) 1997; 16 Gwak (B30) 2021; 23 Saleem (B12) 2020; 51 Kim (B17) 2015; 17 Volny (B15) 2020; 95 Haussen (B7) 2017; 9 Romano (B3) 2015; 72 Kim (B36) 2021; 23 Akbik (B16) 2020; 77 Ko (B21) 2014; 16 Rubin (B27) 2017; 21 |
| References_xml | – volume: 13 start-page: 146 year: 2021 ident: B28 article-title: More expansive horizons: a review of endovascular therapy for patients with low nihss scores publication-title: J Neurointerv Surg. doi: 10.1136/neurintsurg-2020-016583 – volume: 19 start-page: 150 year: 2019 ident: B11 article-title: Efficacy and safety of endovascular thrombectomy in mild ischemic stroke: results from a retrospective study and meta-analysis of previous trials publication-title: BMC Neurol. doi: 10.1186/s12883-019-1372-9 – volume: 16 start-page: 1645 year: 1997 ident: B26 article-title: Test for qualitative interaction of clinical significance publication-title: Stat Med. doi: 10.1002/(SICI)1097-0258(19970730)16:14<1645::AID-SIM596>3.0.CO;2-G – volume: 33 start-page: 1168 year: 2013 ident: B37 article-title: Failure of collateral blood flow is associated with infarct growth in ischemic stroke publication-title: J Cereb Blood Flow Metab. doi: 10.1038/jcbfm.2013.77 – volume: 78 start-page: 21 year: 2020 ident: B33 article-title: Endovascular treatment after stroke due to large vessel occlusion for patients presenting very late from time last known well publication-title: JAMA Neurol. doi: 10.1001/jamaneurol.2020.2804 – volume: 23 start-page: 61 year: 2021 ident: B30 article-title: Perfusion and diffusion variables predict early neurological deterioration in minor stroke and large vessel occlusion publication-title: J Stroke. doi: 10.5853/jos.2020.01466 – volume: 17 start-page: 38 year: 2015 ident: B17 article-title: Case characteristics, hyperacute treatment, and outcome information from the clinical research center for stroke-fifth division registry in South Korea publication-title: J Stroke. doi: 10.5853/jos.2015.17.1.38 – volume: 11 start-page: 1 year: 2004 ident: B24 article-title: Econometric computing with hc and hac covariance matrix estimators publication-title: J Stat Software. doi: 10.18637/jss.v011.i10 – volume: 50 start-page: 2677 year: 2019 ident: B38 article-title: Blood pressure drop and penumbral tissue loss in nonrecanalized emergent large vessel occlusion publication-title: Stroke. doi: 10.1161/STROKEAHA.119.025426 – volume: 18 start-page: 102 year: 2016 ident: B18 article-title: Update of the Korean clinical practice guidelines for endovascular recanalization therapy in patients with acute ischemic stroke publication-title: J Stroke. doi: 10.5853/jos.2015.01655 – volume: 51 start-page: 1458 year: 2020 ident: B6 article-title: Clinical outcome of patients with large vessel occlusion and low national institutes of health stroke scale scores: subanalysis of the rescue-Japan registry 2 publication-title: Stroke. doi: 10.1161/strokeaha.119.028562 – volume: 77 start-page: 16 year: 2020 ident: B4 article-title: Medical management vs mechanical thrombectomy for mild strokes: an international multicenter study and systematic review and meta-analysis publication-title: JAMA Neurol. doi: 10.1001/jamaneurol.2019.3112 – volume: 9 start-page: 917 year: 2017 ident: B7 article-title: Too good to intervene? Thrombectomy for large vessel occlusion strokes with minimal symptoms: an intention-to-treat analysis publication-title: J Neurointerv Surg. doi: 10.1136/neurintsurg-2016-012633 – volume: 23 start-page: 343 year: 2021 ident: B36 article-title: Hemodynamics of leptomeningeal collaterals after large vessel occlusion and blood pressure management with endovascular treatment publication-title: J Stroke. doi: 10.5853/jos.2021.02446 – volume: 78 start-page: 321 year: 2021 ident: B13 article-title: Prediction of early neurological deterioration in individuals with minor stroke and large vessel occlusion intended for intravenous thrombolysis alone publication-title: JAMA Neurol. doi: 10.1001/jamaneurol.2021.2025 – volume: 10 start-page: 325 year: 2018 ident: B8 article-title: Thrombectomy versus medical management for large vessel occlusion strokes with minimal symptoms: an analysis from stopstroke and gestor cohorts publication-title: J Neurointerv Surg. doi: 10.1136/neurintsurg-2017-013243 – volume: 24 start-page: 35 year: 1993 ident: B20 article-title: Classification of subtype of acute ischemic stroke. definitions for use in a multicenter clinical trial. toast. trial of org 10172 in acute stroke treatment publication-title: Stroke. doi: 10.1161/01.STR.24.1.35 – volume: 387 start-page: 1723 year: 2016 ident: B1 article-title: Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials publication-title: Lancet. doi: 10.1016/S0140-6736(16)00163-X – volume: 95 start-page: e2178 year: 2020 ident: B22 article-title: Neurologic deterioration in patients with acute ischemic stroke or transient ischemic attack publication-title: Neurology. doi: 10.1212/WNL.0000000000010603 – volume: 21 start-page: 269 year: 2017 ident: B27 article-title: Do p values lose their meaning in exploratory analyses? It depends how you define the familywise error rate publication-title: Rev Gen Psychol. doi: 10.1037/gpr0000123 – volume: 8 start-page: e70996 year: 2013 ident: B29 article-title: Proximal arterial occlusion in acute ischemic stroke with low nihss scores should not be considered as mild stroke publication-title: PLoS ONE. doi: 10.1371/journal.pone.0070996 – volume: 16 start-page: 161 year: 2014 ident: B21 article-title: Mri-based algorithm for acute ischemic stroke subtype classification publication-title: J Stroke. doi: 10.5853/jos.2014.16.3.161 – volume: 49 start-page: 2398 year: 2018 ident: B32 article-title: Endovascular thrombectomy for mild strokes: how low should we go? publication-title: Stroke. doi: 10.1161/STROKEAHA.118.022114 – volume: 51 start-page: 1428 year: 2020 ident: B12 article-title: Acute neurological deterioration in large vessel occlusions and mild symptoms managed medically publication-title: Stroke. doi: 10.1161/STROKEAHA.119.027011 – volume: 77 start-page: 1486 year: 2020 ident: B16 article-title: Trends in reperfusion therapy for in-hospital ischemic stroke in the endovascular therapy era publication-title: JAMA Neurol. doi: 10.1001/jamaneurol.2020.3362 – volume: 52 start-page: 57 year: 2021 ident: B34 article-title: Early infarct growth rate correlation with endovascular thrombectomy clinical outcomes: analysis from the select study publication-title: Stroke. doi: 10.1161/STROKEAHA.120.030912 – volume: 3 start-page: 29 year: 2018 ident: B14 article-title: Minor stroke due to large artery occlusion when is intravenous thrombolysis not enough? Results from the sits international stroke thrombolysis register publication-title: Eur Stroke J. doi: 10.1177/2396987317746003 – volume: 49 start-page: e46 year: 2018 ident: B19 article-title: 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the american heart association/American stroke association publication-title: Stroke. doi: 10.1161/STR.0000000000000158 – volume: 72 start-page: 423 year: 2015 ident: B3 article-title: Outcomes in mild acute ischemic stroke treated with intravenous thrombolysis: a retrospective analysis of the get with the guidelines-stroke registry publication-title: JAMA Neurol. doi: 10.1001/jamaneurol.2014.4354 – volume: 46 start-page: 2981 year: 2015 ident: B23 article-title: The heidelberg bleeding classification: classification of bleeding events after ischemic stroke and reperfusion therapy publication-title: Stroke. doi: 10.1161/STROKEAHA.115.010049 – volume: 52 start-page: 1847 year: 2021 ident: B35 article-title: Which acute ischemic stroke patients are fast progressors? Results from the escape trial control arm publication-title: Stroke. doi: 10.1161/STROKEAHA.120.032950 – volume: 49 start-page: 2391 year: 2018 ident: B5 article-title: Mechanical thrombectomy in patients with milder strokes and large vessel occlusions publication-title: Stroke. doi: 10.1161/STROKEAHA.118.021106 – volume: 95 start-page: e3364 year: 2020 ident: B15 article-title: Thrombectomy vs medical management in low nihss acute anterior circulation stroke publication-title: Neurology. doi: 10.1212/WNL.0000000000010955 – volume: 4 start-page: 6 year: 2019 ident: B31 article-title: European stroke organisation (Eso) - European society for minimally invasive neurological therapy (esmint) guidelines on mechanical thrombectomy in acute ischemic stroke publication-title: J Neurointerv Surg. doi: 10.1177/2396987319832140 – volume: 17 start-page: 78 year: 2017 ident: B25 article-title: Double-adjustment in propensity score matching analysis: choosing a threshold for considering residual imbalance publication-title: Bmc Med Res Methodol. doi: 10.1186/s12874-017-0338-0 – volume: 49 start-page: 565 year: 2018 ident: B2 article-title: Los Angeles motor scale to identify large vessel occlusion: prehospital validation and comparison with other screens publication-title: Stroke. doi: 10.1161/STROKEAHA.117.019228 – volume: 24 start-page: 3 year: 2022 ident: B39 article-title: Endovascular treatment of large vessel occlusion strokes due to intracranial atherosclerotic disease publication-title: J Stroke. doi: 10.5853/jos.2021.01375 – volume: 267 start-page: 1651 year: 2020 ident: B10 article-title: Outcome of patients with large vessel occlusion in the anterior circulation and low nihss score publication-title: J Neurol. doi: 10.1007/s00415-020-09744-0 – volume: 43 start-page: 3105 year: 2022 ident: B9 article-title: Mechanical thrombectomy in acute ischemic stroke due to large vessel occlusion in the anterior circulation and low baseline national institute of health stroke scale score: a multicenter retrospective matched analysis publication-title: Neurol Sci. doi: 10.1007/s10072-021-05771-5 |
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| Snippet | There is much uncertainty in endovascular treatment (EVT) decisions in patients with acute large vessel occlusion (LVO) and mild neurological deficits.
From a... There is much uncertainty in endovascular treatment (EVT) decisions in patients with acute large vessel occlusion (LVO) and mild neurological... Background and purposeThere is much uncertainty in endovascular treatment (EVT) decisions in patients with acute large vessel occlusion (LVO) and mild... |
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| SubjectTerms | CRCS-K early neurological deterioration endovascular recanalization low NIHSS score mild stroke multicenter registry Neurology |
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| Title | Effectiveness and safety of EVT in patients with acute LVO and low NIHSS |
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