Clinical and Neuroimaging Outcomes of Direct Thrombectomy vs Bridging Therapy in Large Vessel Occlusion: Analysis of the SELECT Cohort Study

Amrou Sarraj, James Grotta, Gregory W Albers, Ameer E Hassan, Spiros Blackburn, Arthur Day, Clark Sitton, Michael Abraham, Chunyan Cai, Mark Dannenbaum, Deep Pujara, William Hicks, Ronald Budzik, Nirav Vora, Ashish Arora, Bader Alenzi, Wondwossen G Tekle, Haris Kamal, Osman Mir, Andrew D Barreto, Maarten Lansberg, Rishi Gupta, Sheryl Martin-Schild, Sean Savitz, Georgios Tsivgoulis, SELECT investigators

Neurology 2021 Apr 19;10.1212/WNL.0000000000012063

Selezionato dal Lettore: dott.ssa Domiziana Rinaldi - Università "La Sapienza" di Roma

MOTIVATION: In this prospective multicenter cohort-study, the Authors investigated safety and efficacy of direct endovascular thrombectomy (dEVT) versus bridging therapy (BT:IV-tPA+EVT) in 226 patients with anterior-circulation large vessel occlusion (LVO). 

The primary outcome was 90-day functional independence evaluated with modified Rankin Scale (mRS); secondary outcomes was a shift across 90-day mRS grades, mortality and symptomatic intracranial hemorrhage.

This study provides class III evidence that in ischemic stroke patients due to LVO within 4.5 hours, bridging therapy compared to direct endovascular thrombectomy leads to better 90-day functional outcomes.