Evolution of Practice During the Interventional Management of Stroke III Trial and Implications for Ongoing Trials
Identifieur interne : 004239 ( Main/Merge ); précédent : 004238; suivant : 004240Evolution of Practice During the Interventional Management of Stroke III Trial and Implications for Ongoing Trials
Auteurs : Joseph P. Broderick [États-Unis] ; Yuko Y. Palesch [États-Unis] ; Andrew M. Demchuk [Canada] ; Sharon D. Yeatts [États-Unis] ; Pooja Khatri [États-Unis] ; Michael D. Hill [Canada] ; Edward C. Jauch [États-Unis] ; Tudor G. Jovin [États-Unis] ; Bernard Yan [Australie] ; Rudiger Von Kummer [Allemagne] ; Carlos A. Molina [Espagne] ; Mayank Goyal [Canada] ; Mikael Mazighi [France] ; Wouter J. Schonewille [Pays-Bas] ; Stefan T. Engelter [Suisse] ; Craig Anderson [Australie] ; Judith Spilker [États-Unis] ; Janice Carrozzella [États-Unis] ; L. Scott Janis [États-Unis] ; Lydia D. Foster [États-Unis] ; Thomas A. Tomsick [États-Unis]Source :
- Stroke : (1970) [ 0039-2499 ] ; 2014.
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Abstract
Background and Purpose-We explored changes in the patient population and practice of endovascular therapy during the course of the Interventional Management of Stroke (IMS) III Trial. Methods-Changes in baseline characteristics, use of baseline CT angiography, treatment times and specifics, and outcomes were compared between the first 4 protocols and the fifth and final protocol. Results-Compared with subjects treated in the first 4 protocol versions (n=610), subjects treated in fifth and final protocol (n=46) were older (75 versus 68 years, P<0.0002) and less likely to have a pretreatment Rankin of 0 (76% versus 89%, P=0.01), were more likely to have a pretreatment CT angiography (65% versus 45%, P=0.009), had quicker median times in the endovascular arm from onset to start of intra-arterial therapy (209 versus 250 minutes, P=0.002) and to reperfusion (269 versus 344 minutes, P<0.0001), had a higher mean dose of total tissue-type plasminogen activator in the endovascular arm (74.0 versus 63.7 mg, P<0.0001), and were less likely to receive intra-arterial tissue-type plasminogen activator as part of the endovascular procedure (16% versus 44%, P=0.015). There were no significant differences in functional and safety outcomes between subjects treated in the 2 treatments arms in either the first 4 protocols or fifth protocol although the small sample size in the fifth protocol provided limited power. Conclusions-Endovascular technology and diagnostic approaches to acute stroke patients changed substantially during the IMS III Trial. Efforts to decrease the time to delivery of endovascular therapy were successful.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Evolution of Practice During the Interventional Management of Stroke III Trial and Implications for Ongoing Trials</title><author><name sortKey="Broderick, Joseph P" sort="Broderick, Joseph P" uniqKey="Broderick J" first="Joseph P." last="Broderick">Joseph P. Broderick</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author><author><name sortKey="Palesch, Yuko Y" sort="Palesch, Yuko Y" uniqKey="Palesch Y" first="Yuko Y." last="Palesch">Yuko Y. Palesch</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Public Health Sciences, Medical University of South Carolina</s1><s2>Charleston</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Charleston</wicri:noRegion></affiliation></author><author><name sortKey="Demchuk, Andrew M" sort="Demchuk, Andrew M" uniqKey="Demchuk A" first="Andrew M." last="Demchuk">Andrew M. Demchuk</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Calgary Stroke Program, Seaman Family MR Research Centre, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary</s1><s2>Calgary, AB</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName><orgName type="university">Université de Calgary</orgName></affiliation></author><author><name sortKey="Yeatts, Sharon D" sort="Yeatts, Sharon D" uniqKey="Yeatts S" first="Sharon D." last="Yeatts">Sharon D. Yeatts</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Public Health Sciences, Medical University of South Carolina</s1><s2>Charleston</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Charleston</wicri:noRegion></affiliation></author><author><name sortKey="Khatri, Pooja" sort="Khatri, Pooja" uniqKey="Khatri P" first="Pooja" last="Khatri">Pooja Khatri</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author><author><name sortKey="Hill, Michael D" sort="Hill, Michael D" uniqKey="Hill M" first="Michael D." last="Hill">Michael D. Hill</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Calgary Stroke Program, Seaman Family MR Research Centre, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary</s1><s2>Calgary, AB</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName><orgName type="university">Université de Calgary</orgName></affiliation></author><author><name sortKey="Jauch, Edward C" sort="Jauch, Edward C" uniqKey="Jauch E" first="Edward C." last="Jauch">Edward C. Jauch</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Emergency Medicine, Medical University of South Carolina</s1><s2>Charleston</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Charleston</wicri:noRegion></affiliation></author><author><name sortKey="Jovin, Tudor G" sort="Jovin, Tudor G" uniqKey="Jovin T" first="Tudor G." last="Jovin">Tudor G. Jovin</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Stroke Institute, University of Pittsburgh Medical Center</s1><s2>Pittsburgh</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Yan, Bernard" sort="Yan, Bernard" uniqKey="Yan B" first="Bernard" last="Yan">Bernard Yan</name><affiliation wicri:level="4"><inist:fA14 i1="06"><s1>Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne</s1><s2>Melbourne, VIC</s2><s3>AUS</s3><sZ>9 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author><author><name sortKey="Von Kummer, Rudiger" sort="Von Kummer, Rudiger" uniqKey="Von Kummer R" first="Rudiger" last="Von Kummer">Rudiger Von Kummer</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neuroradiology, Dresden University Stroke Center, University Hospital</s1><s2>Dresden</s2><s3>DEU</s3><sZ>10 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Molina, Carlos A" sort="Molina, Carlos A" uniqKey="Molina C" first="Carlos A." last="Molina">Carlos A. Molina</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Neurovascular Unit, Department of Neurology, Hospital Universitari Vall d'Hebron</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>11 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Goyal, Mayank" sort="Goyal, Mayank" uniqKey="Goyal M" first="Mayank" last="Goyal">Mayank Goyal</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Calgary Stroke Program, Seaman Family MR Research Centre, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary</s1><s2>Calgary, AB</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName><orgName type="university">Université de Calgary</orgName></affiliation></author><author><name sortKey="Mazighi, Mikael" sort="Mazighi, Mikael" uniqKey="Mazighi M" first="Mikael" last="Mazighi">Mikael Mazighi</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Department of Neurology and Stroke Center, Lariboisiere Hospital</s1><s2>Paris</s2><s3>FRA</s3><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Schonewille, Wouter J" sort="Schonewille, Wouter J" uniqKey="Schonewille W" first="Wouter J." last="Schonewille">Wouter J. Schonewille</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Department of Neurology, University Medical Center Utrecht and the Rudolph Magnus Institute of Neurosciences</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>14 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>St. Antonius Hospital</s1><s2>Nieuwegein</s2><s3>NLD</s3><sZ>14 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>St. Antonius Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Engelter, Stefan T" sort="Engelter, Stefan T" uniqKey="Engelter S" first="Stefan T." last="Engelter">Stefan T. Engelter</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Department of Neurology, Basel University Hospital</s1><s2>Basel</s2><s3>CHE</s3><sZ>15 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Craig" sort="Anderson, Craig" uniqKey="Anderson C" first="Craig" last="Anderson">Craig Anderson</name><affiliation wicri:level="4"><inist:fA14 i1="13"><s1>George Institute for Global Health, Royal Prince Alfred Hospital, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Spilker, Judith" sort="Spilker, Judith" uniqKey="Spilker J" first="Judith" last="Spilker">Judith Spilker</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author><author><name sortKey="Carrozzella, Janice" sort="Carrozzella, Janice" uniqKey="Carrozzella J" first="Janice" last="Carrozzella">Janice Carrozzella</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author><author><name sortKey="Janis, L Scott" sort="Janis, L Scott" uniqKey="Janis L" first="L. Scott" last="Janis">L. Scott Janis</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>National Institute of Neurological Disorders and Stroke, National Institutes of Health</s1><s2>Bethesda, MD</s2><s3>USA</s3><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Bethesda, MD</wicri:noRegion></affiliation></author><author><name sortKey="Foster, Lydia D" sort="Foster, Lydia D" uniqKey="Foster L" first="Lydia D." last="Foster">Lydia D. Foster</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Public Health Sciences, Medical University of South Carolina</s1><s2>Charleston</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Charleston</wicri:noRegion></affiliation></author><author><name sortKey="Tomsick, Thomas A" sort="Tomsick, Thomas A" uniqKey="Tomsick T" first="Thomas A." last="Tomsick">Thomas A. Tomsick</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">15-0012070</idno><date when="2014">2014</date><idno type="stanalyst">PASCAL 15-0012070 INIST</idno><idno type="RBID">Pascal:15-0012070</idno><idno type="wicri:Area/PascalFrancis/Corpus">000128</idno><idno type="wicri:Area/PascalFrancis/Curation">005D25</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000315</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000315</idno><idno type="wicri:doubleKey">0039-2499:2014:Broderick J:evolution:of:practice</idno><idno type="wicri:Area/Main/Merge">004239</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Evolution of Practice During the Interventional Management of Stroke III Trial and Implications for Ongoing Trials</title><author><name sortKey="Broderick, Joseph P" sort="Broderick, Joseph P" uniqKey="Broderick J" first="Joseph P." last="Broderick">Joseph P. Broderick</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author><author><name sortKey="Palesch, Yuko Y" sort="Palesch, Yuko Y" uniqKey="Palesch Y" first="Yuko Y." last="Palesch">Yuko Y. Palesch</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Public Health Sciences, Medical University of South Carolina</s1><s2>Charleston</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Charleston</wicri:noRegion></affiliation></author><author><name sortKey="Demchuk, Andrew M" sort="Demchuk, Andrew M" uniqKey="Demchuk A" first="Andrew M." last="Demchuk">Andrew M. Demchuk</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Calgary Stroke Program, Seaman Family MR Research Centre, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary</s1><s2>Calgary, AB</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName><orgName type="university">Université de Calgary</orgName></affiliation></author><author><name sortKey="Yeatts, Sharon D" sort="Yeatts, Sharon D" uniqKey="Yeatts S" first="Sharon D." last="Yeatts">Sharon D. Yeatts</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Public Health Sciences, Medical University of South Carolina</s1><s2>Charleston</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Charleston</wicri:noRegion></affiliation></author><author><name sortKey="Khatri, Pooja" sort="Khatri, Pooja" uniqKey="Khatri P" first="Pooja" last="Khatri">Pooja Khatri</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author><author><name sortKey="Hill, Michael D" sort="Hill, Michael D" uniqKey="Hill M" first="Michael D." last="Hill">Michael D. Hill</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Calgary Stroke Program, Seaman Family MR Research Centre, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary</s1><s2>Calgary, AB</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName><orgName type="university">Université de Calgary</orgName></affiliation></author><author><name sortKey="Jauch, Edward C" sort="Jauch, Edward C" uniqKey="Jauch E" first="Edward C." last="Jauch">Edward C. Jauch</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Emergency Medicine, Medical University of South Carolina</s1><s2>Charleston</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Charleston</wicri:noRegion></affiliation></author><author><name sortKey="Jovin, Tudor G" sort="Jovin, Tudor G" uniqKey="Jovin T" first="Tudor G." last="Jovin">Tudor G. Jovin</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Stroke Institute, University of Pittsburgh Medical Center</s1><s2>Pittsburgh</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Yan, Bernard" sort="Yan, Bernard" uniqKey="Yan B" first="Bernard" last="Yan">Bernard Yan</name><affiliation wicri:level="4"><inist:fA14 i1="06"><s1>Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne</s1><s2>Melbourne, VIC</s2><s3>AUS</s3><sZ>9 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author><author><name sortKey="Von Kummer, Rudiger" sort="Von Kummer, Rudiger" uniqKey="Von Kummer R" first="Rudiger" last="Von Kummer">Rudiger Von Kummer</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neuroradiology, Dresden University Stroke Center, University Hospital</s1><s2>Dresden</s2><s3>DEU</s3><sZ>10 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Molina, Carlos A" sort="Molina, Carlos A" uniqKey="Molina C" first="Carlos A." last="Molina">Carlos A. Molina</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Neurovascular Unit, Department of Neurology, Hospital Universitari Vall d'Hebron</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>11 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Goyal, Mayank" sort="Goyal, Mayank" uniqKey="Goyal M" first="Mayank" last="Goyal">Mayank Goyal</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Calgary Stroke Program, Seaman Family MR Research Centre, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary</s1><s2>Calgary, AB</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName><orgName type="university">Université de Calgary</orgName></affiliation></author><author><name sortKey="Mazighi, Mikael" sort="Mazighi, Mikael" uniqKey="Mazighi M" first="Mikael" last="Mazighi">Mikael Mazighi</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Department of Neurology and Stroke Center, Lariboisiere Hospital</s1><s2>Paris</s2><s3>FRA</s3><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Schonewille, Wouter J" sort="Schonewille, Wouter J" uniqKey="Schonewille W" first="Wouter J." last="Schonewille">Wouter J. Schonewille</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Department of Neurology, University Medical Center Utrecht and the Rudolph Magnus Institute of Neurosciences</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>14 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>St. Antonius Hospital</s1><s2>Nieuwegein</s2><s3>NLD</s3><sZ>14 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>St. Antonius Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Engelter, Stefan T" sort="Engelter, Stefan T" uniqKey="Engelter S" first="Stefan T." last="Engelter">Stefan T. Engelter</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Department of Neurology, Basel University Hospital</s1><s2>Basel</s2><s3>CHE</s3><sZ>15 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Craig" sort="Anderson, Craig" uniqKey="Anderson C" first="Craig" last="Anderson">Craig Anderson</name><affiliation wicri:level="4"><inist:fA14 i1="13"><s1>George Institute for Global Health, Royal Prince Alfred Hospital, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Spilker, Judith" sort="Spilker, Judith" uniqKey="Spilker J" first="Judith" last="Spilker">Judith Spilker</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author><author><name sortKey="Carrozzella, Janice" sort="Carrozzella, Janice" uniqKey="Carrozzella J" first="Janice" last="Carrozzella">Janice Carrozzella</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author><author><name sortKey="Janis, L Scott" sort="Janis, L Scott" uniqKey="Janis L" first="L. Scott" last="Janis">L. Scott Janis</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>National Institute of Neurological Disorders and Stroke, National Institutes of Health</s1><s2>Bethesda, MD</s2><s3>USA</s3><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Bethesda, MD</wicri:noRegion></affiliation></author><author><name sortKey="Foster, Lydia D" sort="Foster, Lydia D" uniqKey="Foster L" first="Lydia D." last="Foster">Lydia D. Foster</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Public Health Sciences, Medical University of South Carolina</s1><s2>Charleston</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Charleston</wicri:noRegion></affiliation></author><author><name sortKey="Tomsick, Thomas A" sort="Tomsick, Thomas A" uniqKey="Tomsick T" first="Thomas A." last="Tomsick">Thomas A. Tomsick</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Neurology and Rehabilitation Medicine and Radiology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center</s1><s2>Cincinnati</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cincinnati</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Stroke : (1970)</title><title level="j" type="abbreviated">Stroke : (1970)</title><idno type="ISSN">0039-2499</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Stroke : (1970)</title><title level="j" type="abbreviated">Stroke : (1970)</title><idno type="ISSN">0039-2499</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cerebrovascular disease</term><term>Clinical management</term><term>Evolution</term><term>Nervous system diseases</term><term>Stroke</term><term>Treatment</term><term>t-Plasminogen activator</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Accident cérébrovasculaire</term><term>Pathologie du système nerveux</term><term>Pathologie cérébrovasculaire</term><term>Evolution</term><term>Conduite à tenir</term><term>Traitement</term><term>t-Plasminogen activator</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background and Purpose-We explored changes in the patient population and practice of endovascular therapy during the course of the Interventional Management of Stroke (IMS) III Trial. Methods-Changes in baseline characteristics, use of baseline CT angiography, treatment times and specifics, and outcomes were compared between the first 4 protocols and the fifth and final protocol. Results-Compared with subjects treated in the first 4 protocol versions (n=610), subjects treated in fifth and final protocol (n=46) were older (75 versus 68 years, P<0.0002) and less likely to have a pretreatment Rankin of 0 (76% versus 89%, P=0.01), were more likely to have a pretreatment CT angiography (65% versus 45%, P=0.009), had quicker median times in the endovascular arm from onset to start of intra-arterial therapy (209 versus 250 minutes, P=0.002) and to reperfusion (269 versus 344 minutes, P<0.0001), had a higher mean dose of total tissue-type plasminogen activator in the endovascular arm (74.0 versus 63.7 mg, P<0.0001), and were less likely to receive intra-arterial tissue-type plasminogen activator as part of the endovascular procedure (16% versus 44%, P=0.015). There were no significant differences in functional and safety outcomes between subjects treated in the 2 treatments arms in either the first 4 protocols or fifth protocol although the small sample size in the fifth protocol provided limited power. Conclusions-Endovascular technology and diagnostic approaches to acute stroke patients changed substantially during the IMS III Trial. Efforts to decrease the time to delivery of endovascular therapy were successful.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Canada</li><li>Espagne</li><li>France</li><li>Pays-Bas</li><li>Suisse</li><li>États-Unis</li></country><region><li>Alberta</li><li>Catalogne</li><li>District de Dresde</li><li>Nouvelle-Galles du Sud</li><li>Pennsylvanie</li><li>Saxe (Land)</li><li>Utrecht (province)</li><li>Victoria (État)</li><li>Île-de-France</li></region><settlement><li>Barcelone</li><li>Calgary</li><li>Dresde</li><li>Melbourne</li><li>Paris</li><li>Pittsburgh</li><li>Sydney</li><li>Utrecht</li></settlement><orgName><li>Université de Calgary</li><li>Université de Melbourne</li><li>Université de Sydney</li></orgName></list><tree><country name="États-Unis"><noRegion><name sortKey="Broderick, Joseph P" sort="Broderick, Joseph P" uniqKey="Broderick J" first="Joseph P." last="Broderick">Joseph P. Broderick</name></noRegion><name sortKey="Carrozzella, Janice" sort="Carrozzella, Janice" uniqKey="Carrozzella J" first="Janice" last="Carrozzella">Janice Carrozzella</name><name sortKey="Foster, Lydia D" sort="Foster, Lydia D" uniqKey="Foster L" first="Lydia D." last="Foster">Lydia D. Foster</name><name sortKey="Janis, L Scott" sort="Janis, L Scott" uniqKey="Janis L" first="L. Scott" last="Janis">L. Scott Janis</name><name sortKey="Jauch, Edward C" sort="Jauch, Edward C" uniqKey="Jauch E" first="Edward C." last="Jauch">Edward C. Jauch</name><name sortKey="Jovin, Tudor G" sort="Jovin, Tudor G" uniqKey="Jovin T" first="Tudor G." last="Jovin">Tudor G. Jovin</name><name sortKey="Khatri, Pooja" sort="Khatri, Pooja" uniqKey="Khatri P" first="Pooja" last="Khatri">Pooja Khatri</name><name sortKey="Palesch, Yuko Y" sort="Palesch, Yuko Y" uniqKey="Palesch Y" first="Yuko Y." last="Palesch">Yuko Y. Palesch</name><name sortKey="Spilker, Judith" sort="Spilker, Judith" uniqKey="Spilker J" first="Judith" last="Spilker">Judith Spilker</name><name sortKey="Tomsick, Thomas A" sort="Tomsick, Thomas A" uniqKey="Tomsick T" first="Thomas A." last="Tomsick">Thomas A. Tomsick</name><name sortKey="Yeatts, Sharon D" sort="Yeatts, Sharon D" uniqKey="Yeatts S" first="Sharon D." last="Yeatts">Sharon D. Yeatts</name></country><country name="Canada"><region name="Alberta"><name sortKey="Demchuk, Andrew M" sort="Demchuk, Andrew M" uniqKey="Demchuk A" first="Andrew M." last="Demchuk">Andrew M. Demchuk</name></region><name sortKey="Goyal, Mayank" sort="Goyal, Mayank" uniqKey="Goyal M" first="Mayank" last="Goyal">Mayank Goyal</name><name sortKey="Hill, Michael D" sort="Hill, Michael D" uniqKey="Hill M" first="Michael D." last="Hill">Michael D. Hill</name></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Yan, Bernard" sort="Yan, Bernard" uniqKey="Yan B" first="Bernard" last="Yan">Bernard Yan</name></region><name sortKey="Anderson, Craig" sort="Anderson, Craig" uniqKey="Anderson C" first="Craig" last="Anderson">Craig Anderson</name></country><country name="Allemagne"><region name="Saxe (Land)"><name sortKey="Von Kummer, Rudiger" sort="Von Kummer, Rudiger" uniqKey="Von Kummer R" first="Rudiger" last="Von Kummer">Rudiger Von Kummer</name></region></country><country name="Espagne"><region name="Catalogne"><name sortKey="Molina, Carlos A" sort="Molina, Carlos A" uniqKey="Molina C" first="Carlos A." last="Molina">Carlos A. Molina</name></region></country><country name="France"><region name="Île-de-France"><name sortKey="Mazighi, Mikael" sort="Mazighi, Mikael" uniqKey="Mazighi M" first="Mikael" last="Mazighi">Mikael Mazighi</name></region></country><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Schonewille, Wouter J" sort="Schonewille, Wouter J" uniqKey="Schonewille W" first="Wouter J." last="Schonewille">Wouter J. Schonewille</name></region><name sortKey="Schonewille, Wouter J" sort="Schonewille, Wouter J" uniqKey="Schonewille W" first="Wouter J." last="Schonewille">Wouter J. Schonewille</name></country><country name="Suisse"><noRegion><name sortKey="Engelter, Stefan T" sort="Engelter, Stefan T" uniqKey="Engelter S" first="Stefan T." last="Engelter">Stefan T. Engelter</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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