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Factors influencing thrombectomy decision making for primary medium vessel occlusion stroke

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Factors influencing thrombectomy decision making for primary medium vessel occlusion stroke. / Cimflova, Petra; Kappelhof, Manon; Singh, Nishita; Kashani, Nima; Ospel, Johanna Maria; McDonough, Rosalie; Demchuk, Andrew M; Menon, Bijoy K; Sakai, Nobuyuki; Chen, Michael; Fiehler, Jens; Goyal, Mayank.

in: J NEUROINTERV SURG, Jahrgang 14, Nr. 4, 04.2022, S. 350-355.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Cimflova, P, Kappelhof, M, Singh, N, Kashani, N, Ospel, JM, McDonough, R, Demchuk, AM, Menon, BK, Sakai, N, Chen, M, Fiehler, J & Goyal, M 2022, 'Factors influencing thrombectomy decision making for primary medium vessel occlusion stroke', J NEUROINTERV SURG, Jg. 14, Nr. 4, S. 350-355. https://doi.org/10.1136/neurintsurg-2021-017472

APA

Cimflova, P., Kappelhof, M., Singh, N., Kashani, N., Ospel, J. M., McDonough, R., Demchuk, A. M., Menon, B. K., Sakai, N., Chen, M., Fiehler, J., & Goyal, M. (2022). Factors influencing thrombectomy decision making for primary medium vessel occlusion stroke. J NEUROINTERV SURG, 14(4), 350-355. https://doi.org/10.1136/neurintsurg-2021-017472

Vancouver

Cimflova P, Kappelhof M, Singh N, Kashani N, Ospel JM, McDonough R et al. Factors influencing thrombectomy decision making for primary medium vessel occlusion stroke. J NEUROINTERV SURG. 2022 Apr;14(4):350-355. https://doi.org/10.1136/neurintsurg-2021-017472

Bibtex

@article{f15e19f60d124930bc662fe97c803b9b,
title = "Factors influencing thrombectomy decision making for primary medium vessel occlusion stroke",
abstract = "BACKGROUND: We aimed to explore the preference of stroke physicians to treat patients with primary medium vessel occlusion (MeVO) stroke with immediate endovascular treatment (EVT) in an international cross-sectional survey, as there is no clear guideline recommendation for EVT in these patients.METHODS: In the survey MeVO-Finding Rationales and Objectifying New Targets for IntervEntional Revascularization in Stroke (MeVO-FRONTIERS), participants were shown four cases of primary MeVOs (six scenarios per case) and asked whether they would treat those patients with EVT. Multivariable logistic regression with clustering by respondent was performed to assess factors influencing the decision to treat. Dominance analysis was performed to assess the influence of factors within the scenarios on decision making.RESULTS: Overall, 366 participants (56 women; 15%) from 44 countries provided 8784 answers to 24 scenarios. Most physicians (59.2%) would treat patients immediately with EVT. Younger patient age (incidence rate ratio (IRR) 1.24, 99% CI 1.19 to 1.30), higher National Institutes of Health Stroke Scale (NIHSS) score (IRR 1.69, 99% CI 1.57 to 1.82), and small core volume (IRR 1.35, 99% CI 1.24 to 1.46) were positively associated with the decision to treat with EVT. Interventionalists (IRR 1.26, 99% CI 1.01 to 1.56) were more likely to treat patients with MeVO immediately with EVT. In the dominance analysis, factors influencing the decision in favor of EVT were (in order of importance): baseline NIHSS, core volume, alteplase use, patients' age, and occlusion site.CONCLUSIONS: Most physicians in this survey were interventionalists and would treat patients with MeVO stroke immediately with EVT. This finding supports the need for robust clinical evidence.",
author = "Petra Cimflova and Manon Kappelhof and Nishita Singh and Nima Kashani and Ospel, {Johanna Maria} and Rosalie McDonough and Demchuk, {Andrew M} and Menon, {Bijoy K} and Nobuyuki Sakai and Michael Chen and Jens Fiehler and Mayank Goyal",
note = "{\textcopyright} Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2022",
month = apr,
doi = "10.1136/neurintsurg-2021-017472",
language = "English",
volume = "14",
pages = "350--355",
journal = "J NEUROINTERV SURG",
issn = "1759-8478",
publisher = "BMJ PUBLISHING GROUP",
number = "4",

}

RIS

TY - JOUR

T1 - Factors influencing thrombectomy decision making for primary medium vessel occlusion stroke

AU - Cimflova, Petra

AU - Kappelhof, Manon

AU - Singh, Nishita

AU - Kashani, Nima

AU - Ospel, Johanna Maria

AU - McDonough, Rosalie

AU - Demchuk, Andrew M

AU - Menon, Bijoy K

AU - Sakai, Nobuyuki

AU - Chen, Michael

AU - Fiehler, Jens

AU - Goyal, Mayank

N1 - © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2022/4

Y1 - 2022/4

N2 - BACKGROUND: We aimed to explore the preference of stroke physicians to treat patients with primary medium vessel occlusion (MeVO) stroke with immediate endovascular treatment (EVT) in an international cross-sectional survey, as there is no clear guideline recommendation for EVT in these patients.METHODS: In the survey MeVO-Finding Rationales and Objectifying New Targets for IntervEntional Revascularization in Stroke (MeVO-FRONTIERS), participants were shown four cases of primary MeVOs (six scenarios per case) and asked whether they would treat those patients with EVT. Multivariable logistic regression with clustering by respondent was performed to assess factors influencing the decision to treat. Dominance analysis was performed to assess the influence of factors within the scenarios on decision making.RESULTS: Overall, 366 participants (56 women; 15%) from 44 countries provided 8784 answers to 24 scenarios. Most physicians (59.2%) would treat patients immediately with EVT. Younger patient age (incidence rate ratio (IRR) 1.24, 99% CI 1.19 to 1.30), higher National Institutes of Health Stroke Scale (NIHSS) score (IRR 1.69, 99% CI 1.57 to 1.82), and small core volume (IRR 1.35, 99% CI 1.24 to 1.46) were positively associated with the decision to treat with EVT. Interventionalists (IRR 1.26, 99% CI 1.01 to 1.56) were more likely to treat patients with MeVO immediately with EVT. In the dominance analysis, factors influencing the decision in favor of EVT were (in order of importance): baseline NIHSS, core volume, alteplase use, patients' age, and occlusion site.CONCLUSIONS: Most physicians in this survey were interventionalists and would treat patients with MeVO stroke immediately with EVT. This finding supports the need for robust clinical evidence.

AB - BACKGROUND: We aimed to explore the preference of stroke physicians to treat patients with primary medium vessel occlusion (MeVO) stroke with immediate endovascular treatment (EVT) in an international cross-sectional survey, as there is no clear guideline recommendation for EVT in these patients.METHODS: In the survey MeVO-Finding Rationales and Objectifying New Targets for IntervEntional Revascularization in Stroke (MeVO-FRONTIERS), participants were shown four cases of primary MeVOs (six scenarios per case) and asked whether they would treat those patients with EVT. Multivariable logistic regression with clustering by respondent was performed to assess factors influencing the decision to treat. Dominance analysis was performed to assess the influence of factors within the scenarios on decision making.RESULTS: Overall, 366 participants (56 women; 15%) from 44 countries provided 8784 answers to 24 scenarios. Most physicians (59.2%) would treat patients immediately with EVT. Younger patient age (incidence rate ratio (IRR) 1.24, 99% CI 1.19 to 1.30), higher National Institutes of Health Stroke Scale (NIHSS) score (IRR 1.69, 99% CI 1.57 to 1.82), and small core volume (IRR 1.35, 99% CI 1.24 to 1.46) were positively associated with the decision to treat with EVT. Interventionalists (IRR 1.26, 99% CI 1.01 to 1.56) were more likely to treat patients with MeVO immediately with EVT. In the dominance analysis, factors influencing the decision in favor of EVT were (in order of importance): baseline NIHSS, core volume, alteplase use, patients' age, and occlusion site.CONCLUSIONS: Most physicians in this survey were interventionalists and would treat patients with MeVO stroke immediately with EVT. This finding supports the need for robust clinical evidence.

U2 - 10.1136/neurintsurg-2021-017472

DO - 10.1136/neurintsurg-2021-017472

M3 - SCORING: Journal article

C2 - 33947769

VL - 14

SP - 350

EP - 355

JO - J NEUROINTERV SURG

JF - J NEUROINTERV SURG

SN - 1759-8478

IS - 4

ER -