Study Examines Long-term Outcomes for Neurovascular Thrombectomy

Neurovascular thrombectomy may have long-term benefits, researchers reported in a recent study.

Previous research, including the REVASCAT trial, has demonstrated improved outcomes 90 days after a stroke. Researchers wanted to determine whether these benefits are seen in the long term, over a 12-month period.
____________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Do Migraines Increase the Risk for Perioperative Ischemic Stroke?
Could Proton Pump Inhibitors Increase Ischemic Stroke Risk?
_____________________________________________________________________________________________________________________________________________________

For the study, which took place at 4 centers in Catalonia, Spain, patients were randomly assigned to receive medical therapy alone, or medical therapy and neurovascular thrombectomy with Solitaire FR.  There were 103 patients in the medical therapy alone group and 103 patients in the medical therapy plus neurovascular treatment group. Although the study was open label, masked investigators evaluated the 12-month endpoints.

Researchers used disability, measured by the modified Rankin Scale (mRS), as the main secondary outcome at 1 year follow-up. Other secondary outcome measures, such as health-related quality of life, the rate of functional independence, and cognitive function measured by the Trail Making Test, were also employed.

Results at the 12-month follow-up indicated that thrombectomy led to a decrease in disability over the range of the mRS (common adjusted odds ratio, 1.80; 95% confidence interval, 1.09-2.99). It also was linked with improved functional independence. In addition, the thrombectomy group had better health-related quality of life compared with the control group, and the 1-year mortality of the thrombectomy group was 23% versus 24% in the control group.

“At 12 months follow-up, neurovascular thrombectomy reduced post-stroke disability and improved health-related quality of life, indicating sustained benefit. These findings have important clinical and public health implications for evaluating the cost-effectiveness of the intervention in the long term,” the study’s authors concluded.

—Lauren LeBano

Reference

Dávalos A, Cobo E, Molina CA, et al. Safety and efficacy of thrombectomy in acute ischaemic stroke (REVASCAT): 1-year follow-up of a randomised open-label trial. Lancet Neurol. 2017;16(5):369-376.