Effect of direct endovascular treatment versus standard bridging therapy in large artery anterior circulation stroke (DEVT): 18-month follow-up of a randomized controlled trial
机构：[1]Department of Neurology, The First Afliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China[2]Department of Cerebrovascular Diseases, Guangyuan Central Hospital, Guangyuan, Sichuan, China[3]Department of Cerebrovascular Diseases, Zhuhai Hospital Afliated With Jinan University (Zhuhai People’s Hospital), Zhuhai, Guangdong, China[4]Department of Neurology, Xinqiao Hospital and the second afliated hospital of Army Medical University (Third Military Medical University), No. 183 Xinqiao Main Street, Shapingba District, Chongqing 400037, China[5]Department of Neurology, Xiangyang Hospital of Traditional Chinese Medicine, Xiangyang, Hubei, China
BackgroundTwo trials in Chinese population showed that endovascular treatment (EVT) alone was noninferior to alteplase follow by EVT at 90 days. However, results of long-term clinical outcomes remain unknown. We reported the results of prespecified 18-month analysis of the DEVT trail.Materials and methodsWe assessed clinical outcomes 18 months after patients were randomly assigned to receive EVT alone or bridging therapy for acute ischemic stroke (AIS). The primary outcome was the proportion of functional independence [modified Rankin scale (mRS), 0-2] at 18 months. Secondary outcomes included all-cause mortality and the quality of life at 18 months as measured by means of a health utility index according to the European Quality of Life 5-Dimension 5-level scale (EQ-5D-5L). Kaplan-Meier event curves were used to investigate the risk of mortality in participants with EVT alone or bridging therapy.ResultsAmong 234 patients (EVT alone, n = 116; bridging therapy, n = 118) in the DEVT trial, only 231 (98.7%) patients were extended follow-up to 18 months. A total of 60 (51.7%) patients in the EVT alone achieved functional independence vs 56 (47.5%) patients in the bridging therapy (difference, 4.3%; 1-sided 97.5% CI, - 8.4% to infinity, P for noninferiority =0.014). No significant between-group difference was detected in EQ-5D-5L score (0.81 vs 0.73; difference, 0; 95% CI, 0 to 0.005). The cumulative mortality was 27.6% in the EVT alone and 28.8% in the bridging therapy.ConclusionAt 18 months follow-up, EVT alone was noninferior to bridging therapy regarding favorable functional outcome in patients with AIS.
基金：
National Natural Science Foundation of
China (No.82271349) and National Health Commission Project of Hunan
(202203074376).
第一作者机构：[1]Department of Neurology, The First Afliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
共同第一作者：
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推荐引用方式(GB/T 7714)：
Ruan Zhongfan,Luo Xiaojun,Liu Yongkang,et al.Effect of direct endovascular treatment versus standard bridging therapy in large artery anterior circulation stroke (DEVT): 18-month follow-up of a randomized controlled trial[J].BMC NEUROLOGY.2023,23(1):doi:10.1186/s12883-023-03111-y.
APA：
Ruan, Zhongfan,Luo, Xiaojun,Liu, Yongkang,Li, Fengli,Liu, Jincheng&Zi, Wenjie.(2023).Effect of direct endovascular treatment versus standard bridging therapy in large artery anterior circulation stroke (DEVT): 18-month follow-up of a randomized controlled trial.BMC NEUROLOGY,23,(1)
MLA：
Ruan, Zhongfan,et al."Effect of direct endovascular treatment versus standard bridging therapy in large artery anterior circulation stroke (DEVT): 18-month follow-up of a randomized controlled trial".BMC NEUROLOGY 23..1(2023)
