Supplemental material for: Clinical and neuroimaging outcomes of direct endovascular thrombectomy vs. bridging therapy in large vessel occlusion patients: a secondary analysis of SELECT cohort study

Objective: To evaluate the comparative safety and efficacy of direct endovascular thrombectomy(dEVT) compared to bridging therapy(BT:IV-tPA+EVT) and assess if BT potential benefit relates to stroke severity, size and initial presentation to EVT vs. non-EVT center.

Methods: In a prospective multicenter cohort-study of imaging selection for endovascular thrombectomy[SELECT], anterior-circulation large vessel occlusion (LVO) patients presenting to EVT-capable centers within 4.5hours from last-known-well were stratified into BT vs. dEVT. The primary outcome was 90-day functional independence[modified Rankin Scale(mRS)=0-2]. Secondary outcomes included a shift across 90-day mRS grades, mortality, symptomatic intracranial hemorrhage. We also performed subgroup-analyses according to initial presentation to EVT-capable center (direct versus transfer), stroke severity and baseline infarct core volume.

Results: We identified 226 LVOs (54%:men, mean age:65.6±14.6years, median NIHSS-score: 17...

研究目的：评估直接血管内取栓术（direct endovascular thrombectomy，dEVT）与桥接治疗（bridging therapy，BT：静脉溶栓IV-tPA+血管内取栓EVT）相比的相对安全性与有效性，并探究桥接治疗的潜在获益是否与卒中严重程度、梗死体积，以及患者初始就诊于可开展EVT的中心还是非EVT中心相关。研究方法：本研究基于一项针对血管内取栓术影像筛选的前瞻性多中心队列研究[SELECT]，纳入最后正常清醒时间4.5小时内就诊于可开展EVT中心的前循环大血管闭塞（large vessel occlusion，LVO）患者，将其分层为桥接治疗组与直接血管内取栓术组。主要结局指标为90天功能独立（modified Rankin Scale，mRS）评分0~2分。次要结局指标包括90天mRS评分分布移位分析、全因死亡率、症状性颅内出血。本研究还根据患者初始就诊类型（直接就诊vs转诊）、卒中严重程度以及基线梗死核心体积开展了亚组分析。研究结果：本研究共纳入226例大血管闭塞患者（54%为男性，平均年龄65.6±14.6岁，美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）中位评分17……