Back to Search
Start Over
Intra-Arterial Therapy and Post-Treatment Infarct Volumes: Insights From the ESCAPE Randomized Controlled Trial
- Source :
- Stroke. 47(3)
- Publication Year :
- 2016
-
Abstract
- Background and Purpose— The goal of reperfusion therapy in acute ischemic stroke is to limit brain infarction. The objective of this study was to investigate whether the beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in post-treatment infarct volume. Methods— The Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times (ESCAPE) trial was a multicenter randomized open-label trial with blinded outcome evaluation. Among 315 enrolled subjects (endovascular treatment n=165; control n=150), 314 subject’s infarct volumes at 24 to 48 hours on magnetic resonance imaging (n=254) or computed tomography (n=60) were measured. Post-treatment infarct volumes were compared by treatment assignment and recanalization/reperfusion status. Appropriate statistical models were used to assess relationship between baseline clinical and imaging variables, post-treatment infarct volume, and functional status at 90 days (modified Rankin Scale). Results— Median post-treatment infarct volume in all subjects was 21 mL (interquartile range =65 mL), in the intervention arm, 15.5 mL (interquartile range =41.5 mL), and in the control arm, 33.5 mL (interquartile range =84 mL; P P P P P P >0.05). Post-treatment infarct volume ( P P Conclusions— These results support the primary results of the ESCAPE trial and show that the biological underpinning of the success of endovascular therapy is a reduction in infarct volume. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01778335.
- Subjects :
- Male
medicine.medical_specialty
030218 nuclear medicine & medical imaging
law.invention
03 medical and health sciences
0302 clinical medicine
Reperfusion therapy
Randomized controlled trial
law
Modified Rankin Scale
Interquartile range
Internal medicine
medicine
Humans
Infusions, Intra-Arterial
Single-Blind Method
Thrombolytic Therapy
Stroke
Advanced and Specialized Nursing
medicine.diagnostic_test
Cerebral infarction
business.industry
Endovascular Procedures
Magnetic resonance imaging
Cerebral Infarction
medicine.disease
Clinical trial
Treatment Outcome
Anesthesia
Tissue Plasminogen Activator
Cardiology
Female
Neurology (clinical)
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 15244628
- Volume :
- 47
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Stroke
- Accession number :
- edsair.doi.dedup.....1db0f16f3640aa22f573cbc2daea3b5f