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ASA: Benefits for Endovascular Tx Six to 16 Hours After Stroke

Higher percentage of patients functionally independent at 3 months with endovascular therapy

THURSDAY, Jan. 25, 2018 (HealthDay News) — For patients with proximal middle-cerebral-artery or internal-carotid-artery occlusion, endovascular therapy six to 16 hours after they were last known to be well is associated with improved outcomes, according to a study published online Jan. 24 in the New England Journal of Medicine. The research was published to coincide with the American Stroke Association’s International Stroke Conference, held from Jan. 24 to 26 in Los Angeles.

Gregory W. Albers, M.D., from the Stanford University School of Medicine in California, and colleagues randomized patients who had remaining ischemic brain tissue that was not yet infarcted six to 16 hours after they were last known to be well to endovascular therapy plus standard medical therapy (92 patients) or standard medical therapy alone (90 patients).

The researchers found that, compared with medical therapy alone, endovascular therapy plus medical therapy was correlated with a favorable shift in the distribution of functional outcomes on the modified Rankin scale at 90 days (odds ratio, 2.77); in addition, it was associated with a higher percentage of patients who were functionally independent (modified Rankin scale score of 0 to 2; 45 versus 17 percent). The 90-day mortality rate was 14 and 26 percent in the endovascular therapy and medical therapy groups, respectively (P = 0.05).

“Endovascular therapy six to 16 hours after stroke onset plus standard medical therapy resulted in less disability and a higher rate of functional independence at three months than standard medical therapy alone,” the authors write.

Several authors disclosed financial ties to iSchemaView; several authors are named on patents related to the research.

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