El CRAI romandrà tancat del 24 de desembre de 2025 al 6 de gener de 2026. La validació de documents es reprendrà a partir del 7 de gener de 2026.
El CRAI permanecerá cerrado del 24 de diciembre de 2025 al 6 de enero de 2026. La validación de documentos se reanudará a partir del 7 de enero de 2026.
From 2025-12-24 to 2026-01-06, the CRAI remain closed and the documents will be validated from 2026-01-07.
 
Miniatura

Fitxers

909552.pdf (741.59 KB)

Tipus de document

Article

Versió

Versió acceptada

Data de publicació

2025-10-01

Llicència de publicació

cc-by-nc (c) Doncel-Moriano Cubero, A. et al., 2025
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/225087

Trends in revascularization therapies for patients with acute stroke with large infarcts: A population-based study

Títol de la revista

Autors

Director/Tutor

ISSN de la revista

Títol del volum

Recurs relacionat

https://doi.org/10.1136/jnis-2025-023252

Resum

Background Evidence from randomized clinical trials shows that mechanical thrombectomy (MT) enhances functional outcomes in patients with large core ischemic stroke. Objective To evaluate trends in the use of revascularization therapies, particularly MT, and their impact on functional outcomes in patients with large core ischemic stroke in routine clinical settings. Methods Observational data from the Stroke Code Registry of Catalonia (CICAT, 2016–2024) were analyzed. Patients with anterior circulation ischemic stroke and Alberta Stroke Program Early CT Score (ASPECTS) <6, whether treated with reperfusion therapies or not, were included. Statistical analyses included trend analysis and multivariable logistic regression to identify predictors of favorable outcomes (modified Rankin Scale score 0–3 at 90 days) and mortality. Results Among 599 patients, MT use increased significantly from 22% pre-2022 to 36% post-2022. This increase was associated with improved functional outcomes, with favorable outcomes rising from 29% to 43% post-2022. MT was a significant independent predictor of favorable outcomes (OR 3.4, 95% CI 2.1 to 5.5) and reduced mortality (OR 0.46, 95% CI 0.32 to 0.68). Intravenous thrombolysis also improved outcomes (OR 2.1, 95% CI 1.3 to 3.5). The benefit of MT was consistent across ASPECTS subgroups (0–2 and 3–5). Mediation analysis indicated that 88% of improvement could be attributed to increased MT use. Conclusions Increased MT use significantly improved outcomes for patients with large core ischemic stroke, particularly after 2022. Benefits were observed across subgroups, including those with very low ASPECTS. These findings support broadening MT access and suggest the need to update treatment guidelines to consider patients with large ischemic cores, aiming to optimize outcomes in routine clinical practice.

Matèries

Embòlia i trombosi cerebral, Terapèutica

Matèries (anglès)

Cerebral embolism and thrombosis, Therapeutics

Citació

Col·leccions

Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

DONCEL MORIANO, Antonio, RODRÍGUEZ VÁZQUEZ, Alejandro, ROSA, Irene, RUDILOSSO, Salvatore, SERRANO CLERENCIA, Mònica, RENÚ, Arturo, CABERO ARNOLD, Andrea, BLASCO, Jordi, AMARO, Sergio, LLULL, Laura, MOLINA, Carlos a., CARDONA PORTELA, Pere, CAMPS RENOM, Pol, MILLÁN, Mónica, FIGUERAS AGUIRRE, Georgina, RODRÍGUEZ CAMPELLO, Ana, SILVA, Yolanda, PURROY, Francisco, SALVAT, Mercè, VARGAS, Martha, URRA, Xabier, CHAMORRO SÁNCHEZ, Ángel. Trends in revascularization therapies for patients with acute stroke with large infarcts: A population-based study. _Journal of Neurointerventional Surgery_. 2025. Vol. 17, núm. 10, pàgs. 1059-1065. [consulta: 25 de desembre de 2025]. ISSN: 1759-8478. [Disponible a: https://hdl.handle.net/2445/225087]

Exportar metadades

JSON - METS

Compartir registre