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@ARTICLE{Bendszus:265937,
author = {Bendszus, Martin and Fiehler, Jens and Subtil, Fabien and
Bonekamp, Susanne and Aamodt, Anne Hege and Fuentes, Blanca
and Gizewski, Elke R and Hill, Michael D and Krajina,
Antonin and Pierot, Laurent and Simonsen, Claus Z and
Zeleňák, Kamil and Blauenfeldt, Rolf A and Cheng, Bastian
and Denis, Angélique and Deutschmann, Hannes and Dorn,
Franziska and Flottmann, Fabian and Gellißen, Susanne and
Gerber, Johannes C and Goyal, Mayank and Haring, Jozef and
Herweh, Christian and Hopf-Jensen, Silke and Hua, Vi Tuan
and Jensen, Märit and Kastrup, Andreas and Keil, Christiane
Fee and Klepanec, Andrej and Kurča, Egon and Mikkelsen,
Ronni and Möhlenbruch, Markus and Müller-Hülsbeck, Stefan
and Münnich, Nico and Pagano, Paolo and Papanagiotou,
Panagiotis and Petzold, Gabor C and Pham, Mirko and Puetz,
Volker and Raupach, Jan and Reimann, Gernot and Ringleb,
Peter Arthur and Schell, Maximilian and Schlemm, Eckhard and
Schönenberger, Silvia and Tennøe, Bjørn and Ulfert,
Christian and Vališ, Kateřina and Vítková, Eva and
Vollherbst, Dominik F and Wick, Wolfgang and Thomalla,
Götz},
collaboration = {Investigators, TENSION},
othercontributors = {Aamodt, Anne Hege and Adamczewski, Olaf and Alektoror,
Kirill and Alexander, März and Alexandrou, Maria and Alias,
Quentin and Al-Kuzae, Fadha Elawi and Allard, Julien and
Al-Schameri, Rahman and Álvarez, Alberto and Andersen,
Grethe and AnkerlundBlaufeldt, Rolf and Antje, Riedel and
Appelbohm, Hannes and Argren, Maria and Assmann, Anne and
Augustin, Michael and Bach, Elke and Bar, Michal and
Barleben, Maria and Baronnet, Flore and Barrios, Andrés and
Bavúzová, Xénia and BayThomsen, Rikke and Becker, Sandra
and Beer, Sylvia and Behme, Daniel and Bellut, Maximilian
and Bendszus, Martin and Berkefeld, Joachim and Bester,
Maximillian and Bode, Felix J and Boehme, Christian and
Boese, Ramona and Bohmann, Ferdinand and Bonekamp, Susanne
and Borggrefe, Jan and Boss, Erendira Gabriela and
Boutchakova, Maria and Boxhammer, Elfi and Brandhofe,
Annemarie and Breckwoldt, Michael and Brekenfeld, Casper and
Brehm, Alex and Brem, Christian and Breuer, Stella and
Breyer, Tobias and Brodová, Petra and Broocks, Gabriel and
Brosinski, Christoph and Bubel, Nele and Búřil, Jiří and
Čábal, Martin and Casado, Laura and Celis, Elena de and
Chabert, Emmanuel and Charisse, Daniel and Cheng, Bastian
and Chovanec, Vendelín and Cidlinsky, Peter and Cisár,
Juraj and Clarençon, Fréderic and Crozier, Sophie and
Čurdová, Nina and Damaskinos, Michele and Damgaard, Dorte
and Daniš, Martin and Dazinger, Florian and Deb-Chatterji,
Milani and Delalic, Asima and Delekta, Agnieszka and
Delorme, Stephen and Deutschmann, Hannes and Diamandis, Elie
and Diedrichsen, Tove and Doležalová, Irena and Dorn,
Franziska and Dorn, Franziska and du Mesnil de Rochemont,
Richard and DupontHougaard, Kristina and Ebrahimi, Taraneh
and Eff, Florian and Eliášová, Ilona and Enriquez, Brian
and Ergawy, Mostafa and Essig, Fabian and Falkesgaard,
Maiken and Fandler-Höfler, Simon and Fernández, Andrés
and Ferré, Jean-Christophe and Ferrier, Anna and Fiehler,
Jens and Figlewski, Krystian and Fischer, Sebastian and
Fischer, Urs and Flottmann, Fabian and Forbig, Robert and
Förch, Christian and Fromm, Annette and Fuentes, Blanca and
Gaedke, Ines and Galczak, Romana and Galijasevic, Malik and
Ganser, Bernhard and Gattringer, Thomas and Gawlitza,
Matthias and Gelhard, Sarah and Gellißen, Susanne and
Gerber, Johannes and Giannakakis, Michail Panagiotis and
Gindlhuber, Karin and Gizewski, Elke R and Glodny, Bernhard
and Godel, Tim and Goebell, Einar and Goldemund, David and
Görtler, Michael and Goyal, Mayank and Grams, Astrid E and
Gruber, Joachim and Gruber, Katharina and
Günthner-Lengsfeld, Thomas and Haase, Kathrin and
Hacker-Ivan, Floriana and Hallerstig, Erika and Hanning, Uta
and Haring, Jozef and Haršány, Michal and Haršány, Ján
and Hartmann, Christian and Hassler, Eva Maria and
Hauptmann, Kristina and Häusler, Karl Georg and Hecker,
Constantin and Hellstern, Victoria and Henkes, Hans and
Hernández, Victoria and Herweh, Christian and Hilgenfeld,
Tim and Hill, Michael D and Hjort, Niels and HjortJensen,
Nina and Hoelter, Maya and Hoffmann, Karl-Titus and Holst,
Brigitte and Holtmannspoetter, Markus and Hopf-Jensen, Silke
and Hoppe, Julia and Horner, Susanne and HougaardSoerensen,
Leif and Hua, Vi Tuan and Hubert, Alexander and Hurtíková,
Eva and Jakubíček, Stanislava and Janjic, Tanja and
Jaramillo, Kirsten and Jedlitschka, Angela and Jensen,
Schiela and Jensen, Märit and Jesser, Jessica and Jestaedt,
Leonie and Johnson, Sabine and Jonszta, Tomáš and Kalmar,
Peter and Karabegovic, Sanja and Karen, Kollo and Kastrup,
Andreas and Katja, Hopp and Keeba, Natalia and Keese, Petra
and Kefalaykos, Christina and Keil, Fee and Kellert, Lars
and Kellinghaus, Christoph and Kestner, Roxane-Isabelle and
Kiechl, Stefan and Killer-Oberpfalzer, Monika and Klepanec,
Andrej and Knispel, Casjupea and Knoflach, Michael and
Kohler, Sabine and Kohlhase, Konstantin and Kollikowski,
Alexander Marco and Kovář, Martin and Krajina, Antonín
and Kral, Michael and Krastev, Georgi and Krause, Lars Udo
and Kreidenhuber, Rudolf and Křivka, Tomáš and Krkoška,
Adam and Kröger, Jan Robert and Kronlage, Moritz and
Krukowski, Pawel and Kühn, Julia and Kurča, Egon and
Kurka, Natalia and Kuschnerow, Michael and Lachmund, Rita
and Lamprecht, Susanne and Lange, Rüdiger and Lauer, Monika
and Leciñana, Alonso de and Leder, Sara and Leger, Anne and
Lehnen, Nils and Lehrieder, Dominik and Leißner, Maximilian
and Leitinger, Markus and Leitner, Ursula and Lenck,
Stéphanie and Lenzenweger, Eva and Liebig, Thomas and
Lowens, Stephan and Lunzer, Manuel and Maegerlein, Christian
and Magyar, Marton and Marques, Leonardo and Matyáš, David
and Maurer, Gabriele and Mauritz, Matthias and Maximilian,
Thormann and Mayer-Süß, Lukas and Meckel, Stephan and
Medek, Oldřich and Meissner, Julius N and Mencl, Pavel and
Merkle, Andrea and Mesche, Birte and Michalski, Dominik and
Mikulík, Robert and Modrau, Boris and Möhlenbruch, Markus
A and Mohr, Alexander and Mönninghoff, Christoph and Moser,
Tobias and Mücke, Ramona and Müller-Hülsbeck, Stefan and
Müller-Thies-Broussalis, Erasmia and Mutzenbach, Sebastian
and Navia, Pedro and Neuberger, Ulf and Neugebauer, Hermann
and Neumann, Jens and Nguyên, Anh and Niederkorn, Kurt and
Nosál', Vladimír and Novobilský, Richard and Ntoulias,
Nikos and Nussbaum, Lukas and Oder, Joanna and Oldag,
Andreas and Ondrejkovič, Marián and Otto, Ferdinand and
Otto, Dagmar and Paech, Daniel and Pagano, Paolo and
Pallesen, Lars-Peder and Panský, Michal and Papanagiotou,
Panagiotis and Patrick, Samp and Paukisch, Harald and Pelz,
Johann and Petersen, Inga and Petersen, Martina and Petzold,
Gabor C and Pfaff, Johannes and Pfaff, Johannes and
Pfeilschifter, Waltraud and Pham, Mirko and Pichler,
Alexander and Pierot, Laurent and Pikija, Slaven and
PlougmannPovlsen, Jan and Polkowski, Christoph and Polomac,
Nenad and Portugaller, Rupert Horst and Poulsen, Marika and
Preiß, Michael and Premat, Kévin and Prestsæter, Sjur and
Prieto-Pérez, Rocio and Psychogios, Marios and Puetz,
Volker and Purrucker, Jan and Rai, Heike and Rauch,
Maximilian and Raupach, Jan and Reimann, Gernot and Reimann,
Georg and Reitz, Sarah and Renc, Ondřej and Retzlaff,
Jasmin and Rigual, Ricardo and Ringleb, Peter Arthur and
Rivera-Bengoa, Carlota and Rodríguez, Jorge and Rohde,
Stefan and Rohler, Siegfried and Rosso, Charlotte and Roth,
Christian and Röttcher, Thomas and Roubec, Martin and
Roztočilová, Milada and Rudnicka, Svetlana and Ruiz,
Gerardo and Ryan, Stephen and Ryckborst, Karla J and
Sandvik, Simen and Schäfer, Jan-Hendrik and Schaller-Paule,
Martin and Schell, Maximillian and Schellinger, Peter and
Schlemm, Eckhard and Schmid, Florian and Schmidt, Christoph
and Schmitz, Marie Louise and Schneider, Claus and Scholtz,
Jan-Erik and Schönenberger, Silvia and Schröter, Andreas
and Schwarz, Daniel and Schwarz, Stephan and Schwarzenhofer,
Daniel and Seifert-Held, Thomas and Seiler, Alexander and
Seker, Fatih and Shotar, Eimad and Simonsen, Claus Z and
Simonsen, Maria Theresa and Sivák, Jozef and Skagen,
Karolina and Skjelland, Mona and Šnajdrová, Alena and
Solymosi, Lazlo and Sømark, Jesper and Sonnberger, Michael
and Soršák, Jakub and Sourour, Nader and Søyland, Jogrim
and Spitzer, Daniel and Sporns, Peter and Städt, Michael
and Steidl, Eike and Størdal, Anne Margrethe Kaalaas and
Stösser, Sebastian and Strickmann, Sarah and Strýček,
Ondřej and Suškevič, Igor and Sýkora, Jan and Tennøe,
Bjørn and Thaler, Daniela and Theisen, Sara and Thomalla,
Götz and Trendafilov, Petar and Trenkler, Johannes and
Trumm, Christoph and Tsogkas, Ioannis and Tunold, Jon-Anders
and Tveit, Lars and Ulfert, Christian and Vališ, Kateřina
and Vaníček, Jiří and Vassilev, Christine and Vítková,
Eva and Voit-Höhne, Heinz-Leonhard and Vojtíšek, Bohuslav
and Volderauer, Karoline and Vollherbst, Dominik and
Vollmuth, Christoph and Volna, Kamila and Volný, Ondřej
and VonWeitzel-Mudersbach, Poul and Vorčák, Martin and
Wagner, Marlies and Wathle, Gaute Kjellevold and Weber,
Werner and Weber, Anushe and Weiss, Viktor and Weller,
Johannes M and Wenger-Alakmeh, Katharina and Weyland, Cyrill
and Weymayr, Friedrich and Wießpeiner, Ulrike and Willeit,
Johannes and Wittwer, Aymeric and Wollenweber, Frank and
Wortmann, Ginette and Wunderlich, Silke and Xiong, Yanyan
and You, Se-Jong and ZachoSpeiser, Lasse and Zelenak, Kamil
and Zeleňáková, Jana and Zubel, Seraphine},
title = {{E}ndovascular thrombectomy for acute ischaemic stroke with
established large infarct: multicentre, open-label,
randomised trial.},
journal = {The lancet},
volume = {402},
number = {10414},
issn = {0140-6736},
address = {London [u.a.]},
publisher = {Elsevier},
reportid = {DZNE-2023-01060},
pages = {1753 - 1763},
year = {2023},
abstract = {Recent evidence suggests a beneficial effect of
endovascular thrombectomy in acute ischaemic stroke with
large infarct; however, previous trials have relied on
multimodal brain imaging, whereas non-contrast CT is mostly
used in clinical practice.In a prospective multicentre,
open-label, randomised trial, patients with acute ischaemic
stroke due to large vessel occlusion in the anterior
circulation and a large established infarct indicated by an
Alberta Stroke Program Early Computed Tomographic Score
(ASPECTS) of 3-5 were randomly assigned using a central,
web-based system (using a 1:1 ratio) to receive either
endovascular thrombectomy with medical treatment or medical
treatment (ie, standard of care) alone up to 12 h from
stroke onset. The study was conducted in 40 hospitals in
Europe and one site in Canada. The primary outcome was
functional outcome across the entire range of the modified
Rankin Scale at 90 days, assessed by investigators masked to
treatment assignment. The primary analysis was done in the
intention-to-treat population. Safety endpoints included
mortality and rates of symptomatic intracranial haemorrhage
and were analysed in the safety population, which included
all patients based on the treatment they received. This
trial is registered with ClinicalTrials.gov,
NCT03094715.From July 17, 2018, to Feb 21, 2023, 253
patients were randomly assigned, with 125 patients assigned
to endovascular thrombectomy and 128 to medical treatment
alone. The trial was stopped early for efficacy after the
first pre-planned interim analysis. At 90 days, endovascular
thrombectomy was associated with a shift in the distribution
of scores on the modified Rankin Scale towards better
outcome (adjusted common OR 2·58 $[95\%$ CI 1·60-4·15];
p=0·0001) and with lower mortality (hazard ratio 0·67
$[95\%$ CI 0·46-0·98]; p=0·038). Symptomatic intracranial
haemorrhage occurred in seven $(6\%)$ patients with
thrombectomy and in six $(5\%)$ with medical treatment
alone.Endovascular thrombectomy was associated with improved
functional outcome and lower mortality in patients with
acute ischaemic stroke from large vessel occlusion with
established large infarct in a setting using non-contrast CT
as the predominant imaging modality for patient selection.EU
Horizon 2020.},
keywords = {Humans / Stroke: diagnostic imaging / Stroke: surgery /
Brain Ischemia: diagnostic imaging / Brain Ischemia: surgery
/ Prospective Studies / Thrombectomy: methods / Intracranial
Hemorrhages: etiology / Ischemic Stroke: diagnostic imaging
/ Ischemic Stroke: surgery / Endovascular Procedures:
methods / Infarction: complications / Alberta / Treatment
Outcome},
cin = {AG Petzold ; AG Petzold},
ddc = {610},
cid = {I:(DE-2719)1013020},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37837989},
doi = {10.1016/S0140-6736(23)02032-9},
url = {https://pub.dzne.de/record/265937},
}
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