Endovascular Thrombectomy Versus Medical Management in Isolated M2 Occlusions: Pooled Patient-Level Analysis from the EXTEND-IA Trials, INSPIRE, and SELECT Studies

A Sarraj; M Parsons; A Bivard; AE Hassan; MG Abraham; T Wu; T Kleinig; L Lin; C Chen; C Levi; Q Dong; X Cheng; KS Butcher; P Choi; N Yassi; D Shah; G Sharma; D Pujara; F Shaker; S Blackburn; H Dewey; V Thijs; CW Sitton; GA Donnan; PJ Mitchell; B Yan; JG Grotta; GW Albers; SM Davis; B Campbell

Journal article

Endovascular Thrombectomy Versus Medical Management in Isolated M2 Occlusions: Pooled Patient-Level Analysis from the EXTEND-IA Trials, INSPIRE, and SELECT Studies

A Sarraj, M Parsons, A Bivard, AE Hassan, MG Abraham, T Wu, T Kleinig, L Lin, C Chen, C Levi, Q Dong, X Cheng, KS Butcher, P Choi, N Yassi, D Shah, G Sharma, D Pujara, F Shaker, S Blackburn Show all

Annals of Neurology | WILEY | Published : 2022

DOI: 10.1002/ana.26331

Abstract

Objective: The objective of this study was to evaluate functional and safety outcomes of endovascular thrombectomy (EVT) versus medical management (MM) in patients with M2 occlusion and examine their association with perfusion imaging mismatch and stroke severity. Methods: In a pooled, patient-level analysis of 3 randomized controlled trials (EXTEND-IA, EXTEND-and IA-TNK parts 1 and 2) and 2 prospective nonrandomized studies (INSPIRE and SELECT), we evaluated EVT association with 90-day functional independence (modified Rankin Scale [mRS] = 0–2) in isolated M2 occlusions as compared to medical management overall and in subgroups by mismatch profile status and stroke severity. Results: We inc..

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University of Melbourne Researchers

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Grants

Funding Acknowledgements

The SELECT study was funded by a grant from Stryker Neurovascular to the University of Texas McGovern Medical School at Houston. The EXTEND-IA and EXTEND-IA TNK, and EXTEND-IA TNK Part II trials were supported by grants from the Australian National Health and Medical Research Council of Australia, Royal Australasian College of Physicians, Royal Melbourne Hospital Foundation, the National Heart Foundation of Australia, and the National Stroke Foundation of Australia, and by infrastructure funding from the state government of Victoria. For EXTEND-IA, the Solitaire FR device and trial infrastructure were provided under an unrestricted grant from Covidien. The EXTEND-IA TNK trial was also supported by an unrestricted grant from Medtronic. The INSPIRE Stroke registry was funded by the National Health and Medical Research Council Partnership Project. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.