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<meta name="DC.Title" content="Posttreatment Infarct Volumes when Compared with 24-Hour and 90-Day Clinical Outcomes: Insights from the REVASCAT Randomized Controlled Trial" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5463" />
<meta name="DC.Date" content="2018-01-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2018 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Endovascular therapy has become the standard of care for patients with disabling anterior circulation ischemic stroke due to proximal intracranial thrombi. Our aim was to determine whether the beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in posttreatment infarct volume in the Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT) trial.

MATERIALS AND METHODS: The REVASCAT trial was a multicenter randomized open-label trial with blinded outcome evaluation. Among 206 enrolled subjects (endovascular treatment, n = 103; control, n = 103), posttreatment infarct volume was measured in 204 subjects. Posttreatment infarct volumes were compared with treatment assignment and recanalization status. Appropriate statistical models were used to assess the relationship among baseline clinical and imaging variables, posttreatment infarct volume, the 24-hour NIHSS score, and functional status with the 90-day modified Rankin Scale score.

RESULTS: The median posttreatment infarct volume in all subjects was 23.7 mL (interquartile range = 68.9 mL) and 16.3 mL (interquartile range = 50.2 mL) in the endovascular treatment arm and 38.6 mL (interquartile range = 74.9 mL) in the control arm ( P = .02 for endovascular treatment versus control subjects). Baseline NIHSS ( P &lt; .01), site of occlusion ( P &lt; .03), baseline NCCT ASPECTS ( P &lt; .01), and recanalization status ( P = .02) were independently associated with posttreatment infarct volume. Baseline NIHSS ( P &lt; .01), time from symptom onset to randomization ( P = .02), treatment type ( P = .04), and recanalization status ( P &lt; .01) were independently associated with the 24-hour NIHSS scores. The 24-hour NIHSS score strongly mediated the relationship between treatment type and 90-day mRS ( P &lt; .01 for indirect effect when adjusted for age), while posttreatment infarct volume did not ( P = .26).

CONCLUSIONS: Endovascular treatment saves brain and improves 90-day clinical outcomes primarily through a beneficial effect on the 24-hour stroke severity.

EVT
:   endovascular treatment
IQR
:   interquartile range" />
<meta name="DC.Contributor" content="F.S. Al-Ajlan" />
<meta name="DC.Contributor" content="A.S. Al Sultan" />
<meta name="DC.Contributor" content="P. Minhas" />
<meta name="DC.Contributor" content="Z. Assis" />
<meta name="DC.Contributor" content="M.A. de Miquel" />
<meta name="DC.Contributor" content="M. Millán" />
<meta name="DC.Contributor" content="L. San Román" />
<meta name="DC.Contributor" content="A. Tomassello" />
<meta name="DC.Contributor" content="A.M. Demchuk" />
<meta name="DC.Contributor" content="T.G. Jovin" />
<meta name="DC.Contributor" content="P. Cuadras" />
<meta name="DC.Contributor" content="A. Dávalos" />
<meta name="DC.Contributor" content="M. Goyal" />
<meta name="DC.Contributor" content="B.K. Menon" />
<meta name="article:published_time" content="2018-01-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Posttreatment Infarct Volumes when Compared with 24-Hour and 90-Day Clinical Outcomes: Insights from the REVASCAT Randomized Controlled Trial" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Endovascular therapy has become the standard of care for patients with disabling anterior circulation ischemic stroke due to proximal intracranial thrombi. Our aim was to determine whether the beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in posttreatment infarct volume in the Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT) trial.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;The REVASCAT trial was a multicenter randomized open-label trial with blinded outcome evaluation. Among 206 enrolled subjects (endovascular treatment, &lt;i&gt;n&lt;/i&gt; = 103; control, &lt;i&gt;n&lt;/i&gt; = 103), posttreatment infarct volume was measured in 204 subjects. Posttreatment infarct volumes were compared with treatment assignment and recanalization status. Appropriate statistical models were used to assess the relationship among baseline clinical and imaging variables, posttreatment infarct volume, the 24-hour NIHSS score, and functional status with the 90-day modified Rankin Scale score.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The median posttreatment infarct volume in all subjects was 23.7 mL (interquartile range = 68.9 mL) and 16.3 mL (interquartile range = 50.2 mL) in the endovascular treatment arm and 38.6 mL (interquartile range = 74.9 mL) in the control arm (&lt;i&gt;P&lt;/i&gt; = .02 for endovascular treatment versus control subjects). Baseline NIHSS (&lt;i&gt;P&lt;/i&gt; &amp;lt; .01), site of occlusion (&lt;i&gt;P&lt;/i&gt; &amp;lt; .03), baseline NCCT ASPECTS (&lt;i&gt;P&lt;/i&gt; &amp;lt; .01), and recanalization status (&lt;i&gt;P&lt;/i&gt; = .02) were independently associated with posttreatment infarct volume. Baseline NIHSS (&lt;i&gt;P&lt;/i&gt; &amp;lt; .01), time from symptom onset to randomization (&lt;i&gt;P&lt;/i&gt; = .02), treatment type (&lt;i&gt;P&lt;/i&gt; = .04), and recanalization status (&lt;i&gt;P&lt;/i&gt; &amp;lt; .01) were independently associated with the 24-hour NIHSS scores. The 24-hour NIHSS score strongly mediated the relationship between treatment type and 90-day mRS (&lt;i&gt;P&lt;/i&gt; &amp;lt; .01 for indirect effect when adjusted for age), while posttreatment infarct volume did not (&lt;i&gt;P&lt;/i&gt; = .26).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Endovascular treatment saves brain and improves 90-day clinical outcomes primarily through a beneficial effect on the 24-hour stroke severity.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A5463" />
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<meta name="citation_author" content="F.S. Al-Ajlan" />
<meta name="citation_author_institution" content="aFrom the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada" />
<meta name="citation_author_institution" content="bDepartment of Neurosciences at King Faisal Specialist Hospital and Research Centre (F.S.A.-A.), Riyadh, Saudi Arabia" />
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<meta name="citation_author_institution" content="aFrom the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada" />
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<meta name="citation_author" content="P. Minhas" />
<meta name="citation_author_institution" content="aFrom the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada" />
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<meta name="twitter:title" content="Posttreatment Infarct Volumes when Compared with 24-Hour and 90-Day Clinical Outcomes: Insights from the REVASCAT Randomized Controlled Trial" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Endovascular therapy has become the standard of care for patients with disabling anterior circulation ischemic stroke due to proximal intracranial thrombi. Our aim was to determine whether the beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in posttreatment infarct volume in the Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT) trial.

MATERIALS AND METHODS: The REVASCAT trial was a multicenter randomized open-label trial with blinded outcome evaluation. Among 206 enrolled subjects (endovascular treatment, n = 103; control, n = 103), posttreatment infarct volume was measured in 204 subjects. Posttreatment infarct volumes were compared with treatment assignment and recanalization status. Appropriate statistical models were used to assess the relationship among baseline clinical and imaging variables, posttreatment infarct volume, the 24-hour NIHSS score, and functional status with the 90-day modified Rankin Scale score.

RESULTS: The median posttreatment infarct volume in all subjects was 23.7 mL (interquartile range = 68.9 mL) and 16.3 mL (interquartile range = 50.2 mL) in the endovascular treatment arm and 38.6 mL (interquartile range = 74.9 mL) in the control arm ( P = .02 for endovascular treatment versus control subjects). Baseline NIHSS ( P &lt; .01), site of occlusion ( P &lt; .03), baseline NCCT ASPECTS ( P &lt; .01), and recanalization status ( P = .02) were independently associated with posttreatment infarct volume. Baseline NIHSS ( P &lt; .01), time from symptom onset to randomization ( P = .02), treatment type ( P = .04), and recanalization status ( P &lt; .01) were independently associated with the 24-hour NIHSS scores. The 24-hour NIHSS score strongly mediated the relationship between treatment type and 90-day mRS ( P &lt; .01 for indirect effect when adjusted for age), while posttreatment infarct volume did not ( P = .26).

CONCLUSIONS: Endovascular treatment saves brain and improves 90-day clinical outcomes primarily through a beneficial effect on the 24-hour stroke severity.

EVT
:   endovascular treatment
IQR
:   interquartile range" />
<meta name="og-title" property="og:title" content="Posttreatment Infarct Volumes when Compared with 24-Hour and 90-Day Clinical Outcomes: Insights from the REVASCAT Randomized Controlled Trial" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/1/107" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Endovascular therapy has become the standard of care for patients with disabling anterior circulation ischemic stroke due to proximal intracranial thrombi. Our aim was to determine whether the beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in posttreatment infarct volume in the Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT) trial.

MATERIALS AND METHODS: The REVASCAT trial was a multicenter randomized open-label trial with blinded outcome evaluation. Among 206 enrolled subjects (endovascular treatment, n = 103; control, n = 103), posttreatment infarct volume was measured in 204 subjects. Posttreatment infarct volumes were compared with treatment assignment and recanalization status. Appropriate statistical models were used to assess the relationship among baseline clinical and imaging variables, posttreatment infarct volume, the 24-hour NIHSS score, and functional status with the 90-day modified Rankin Scale score.

RESULTS: The median posttreatment infarct volume in all subjects was 23.7 mL (interquartile range = 68.9 mL) and 16.3 mL (interquartile range = 50.2 mL) in the endovascular treatment arm and 38.6 mL (interquartile range = 74.9 mL) in the control arm ( P = .02 for endovascular treatment versus control subjects). Baseline NIHSS ( P &lt; .01), site of occlusion ( P &lt; .03), baseline NCCT ASPECTS ( P &lt; .01), and recanalization status ( P = .02) were independently associated with posttreatment infarct volume. Baseline NIHSS ( P &lt; .01), time from symptom onset to randomization ( P = .02), treatment type ( P = .04), and recanalization status ( P &lt; .01) were independently associated with the 24-hour NIHSS scores. The 24-hour NIHSS score strongly mediated the relationship between treatment type and 90-day mRS ( P &lt; .01 for indirect effect when adjusted for age), while posttreatment infarct volume did not ( P = .26).

CONCLUSIONS: Endovascular treatment saves brain and improves 90-day clinical outcomes primarily through a beneficial effect on the 24-hour stroke severity.

EVT
:   endovascular treatment
IQR
:   interquartile range" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node57834--5" data-node-nid="57834" id="top-node-57834--61955127539" data-pisa="ajnr;39/1/107" data-pisa-master="ajnr;ajnr.A5463" data-apath="/ajnr/39/1/107.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Interventional</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Posttreatment Infarct Volumes when Compared with 24-Hour and 90-Day Clinical Outcomes: Insights from the REVASCAT Randomized Controlled Trial</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">F.S. Al-Ajlan</span>, <span class="highwire-citation-author" data-delta="1">A.S. Al Sultan</span>, <span class="highwire-citation-author" data-delta="2">P. Minhas</span>, <span class="highwire-citation-author" data-delta="3">Z. Assis</span>, <span class="highwire-citation-author" data-delta="4">M.A. de Miquel</span>, <span class="highwire-citation-author" data-delta="5">M. Millán</span>, <span class="highwire-citation-author" data-delta="6">L. San Román</span>, <span class="highwire-citation-author" data-delta="7">A. Tomassello</span>, <span class="highwire-citation-author" data-delta="8">A.M. Demchuk</span>, <span class="highwire-citation-author" data-delta="9">T.G. Jovin</span>, <span class="highwire-citation-author" data-delta="10">P. Cuadras</span>, <span class="highwire-citation-author" data-delta="11">A. Dávalos</span>, <span class="highwire-citation-author" data-delta="12">M. Goyal</span> and <span class="highwire-citation-author" data-delta="13">B.K. Menon</span> <span  class="highwire-citation-author last"><span class="nlm-on-behalf-of"><span class="span" data-class="nlm-on-behalf-of">for the REVASCAT Investigators</span></span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">January 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">107-110; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5463 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-57834--61955127539" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">F.S. Al-Ajlan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurosciences at King Faisal Specialist Hospital and Research Centre (F.S.A.-A.), Riyadh, Saudi Arabia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.S.%2BAl-Ajlan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Al-Ajlan%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.S.%2BAl-Ajlan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-0501-479X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F.S. Al-Ajlan</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A.S. Al Sultan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.S.%2BAl%2BSultan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Al%20Sultan%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.S.%2BAl%2BSultan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-2849-5386" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.S. Al Sultan</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">P. Minhas </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BMinhas%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Minhas%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.%2BMinhas%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-5209-2897" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Minhas</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Z. Assis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Z.%2BAssis%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Assis%20Z&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AZ.%2BAssis%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-9907-4840" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Z. Assis</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M.A. de Miquel </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Stroke Unit (M.A.d.M.), Neurology Department, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.A.%2Bde%2BMiquel%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=de%20Miquel%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.A.%2Bde%2BMiquel%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-4730-9913" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.A. de Miquel</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">M. Millán </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Stroke Unit (M.M., P.C., A.D.), Department of Neurosciences and Department of Radiology, Hospital Germans Trias, Universitat Autosome de Barcelona, Badalona (Barcelona), Spain</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BMill%C3%A1n%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mill%C3%A1n%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BMill%25C3%25A1n%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4692-5936" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Millán</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">L. San Román </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Stroke Unit (L.S.R.), Neurology Department, Hospital Clínic, Barcelona, Spain</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BSan%2BRom%C3%A1n%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=San%20Rom%C3%A1n%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BSan%2BRom%25C3%25A1n%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0735-4373" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. San Román</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">A. Tomassello </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Stroke Unit (A.T.), Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BTomassello%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tomassello%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BTomassello%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-6736-1535" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Tomassello</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">A.M. Demchuk </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.M.%2BDemchuk%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Demchuk%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.M.%2BDemchuk%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4930-7789" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.M. Demchuk</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">T.G. Jovin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Stroke Institute (T.G.J.), Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.G.%2BJovin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Jovin%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.G.%2BJovin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-2619-6975" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T.G. Jovin</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">P. Cuadras </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Stroke Unit (M.M., P.C., A.D.), Department of Neurosciences and Department of Radiology, Hospital Germans Trias, Universitat Autosome de Barcelona, Badalona (Barcelona), Spain</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BCuadras%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Cuadras%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.%2BCuadras%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-6319-6846" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Cuadras</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">A. Dávalos </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Stroke Unit (M.M., P.C., A.D.), Department of Neurosciences and Department of Radiology, Hospital Germans Trias, Universitat Autosome de Barcelona, Badalona (Barcelona), Spain</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BD%C3%A1valos%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=D%C3%A1valos%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BD%25C3%25A1valos%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-2949-5679" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Dávalos</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">M. Goyal </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BGoyal%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Goyal%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BGoyal%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-9060-2109" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Goyal</a></li></ul></div><div class="author-tooltip-13"><div class="author-tooltip-name">B.K. Menon </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Clinical Neurosciences and Department of Radiology (F.S.A.-A., A.S.A.S., P.M., Z.A., A.M.D., M.G., B.K.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.K.%2BMenon%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Menon%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.K.%2BMenon%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3466-496X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B.K. Menon</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Endovascular therapy has become the standard of care for patients with disabling anterior circulation ischemic stroke due to proximal intracranial thrombi. Our aim was to determine whether the beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in posttreatment infarct volume in the Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT) trial.</p></div><div id="sec-2" class="subsection"><p id="p-3"><strong>MATERIALS AND METHODS:</strong> The REVASCAT trial was a multicenter randomized open-label trial with blinded outcome evaluation. Among 206 enrolled subjects (endovascular treatment, <em>n</em> = 103; control, <em>n</em> = 103), posttreatment infarct volume was measured in 204 subjects. Posttreatment infarct volumes were compared with treatment assignment and recanalization status. Appropriate statistical models were used to assess the relationship among baseline clinical and imaging variables, posttreatment infarct volume, the 24-hour NIHSS score, and functional status with the 90-day modified Rankin Scale score.</p></div><div id="sec-3" class="subsection"><p id="p-4"><strong>RESULTS:</strong> The median posttreatment infarct volume in all subjects was 23.7 mL (interquartile range = 68.9 mL) and 16.3 mL (interquartile range = 50.2 mL) in the endovascular treatment arm and 38.6 mL (interquartile range = 74.9 mL) in the control arm (<em>P</em> = .02 for endovascular treatment versus control subjects). Baseline NIHSS (<em>P</em> &lt; .01), site of occlusion (<em>P</em> &lt; .03), baseline NCCT ASPECTS (<em>P</em> &lt; .01), and recanalization status (<em>P</em> = .02) were independently associated with posttreatment infarct volume. Baseline NIHSS (<em>P</em> &lt; .01), time from symptom onset to randomization (<em>P</em> = .02), treatment type (<em>P</em> = .04), and recanalization status (<em>P</em> &lt; .01) were independently associated with the 24-hour NIHSS scores. The 24-hour NIHSS score strongly mediated the relationship between treatment type and 90-day mRS (<em>P</em> &lt; .01 for indirect effect when adjusted for age), while posttreatment infarct volume did not (<em>P</em> = .26).</p></div><div id="sec-4" class="subsection"><p id="p-5"><strong>CONCLUSIONS:</strong> Endovascular treatment saves brain and improves 90-day clinical outcomes primarily through a beneficial effect on the 24-hour stroke severity.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">EVT<span class="def-item-dt-sep"></span></dt><dd>endovascular treatment<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">IQR<span class="def-item-dt-sep"></span></dt><dd>interquartile range</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2018 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org" rel="license">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/39/1/107.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 39</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 1 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jan 2018 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">F.S.</span> <span class="nlm-surname">Al-Ajlan</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.S.</span> <span class="nlm-surname">Al Sultan</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Minhas</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Z.</span> <span class="nlm-surname">Assis</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.A.</span> <span class="nlm-surname">de Miquel</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Millán</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">L.</span> <span class="nlm-surname">San Román</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Tomassello</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.M.</span> <span class="nlm-surname">Demchuk</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">T.G.</span> <span class="nlm-surname">Jovin</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Cuadras</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Dávalos</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Goyal</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">B.K.</span> <span class="nlm-surname">Menon</span></span></span></div>
  
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      <div class="highwire-cite-title">Posttreatment Infarct Volumes when Compared with 24-Hour and 90-Day Clinical Outcomes: Insights from the REVASCAT Randomized Controlled Trial</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">F.S.</span> <span class="nlm-surname">Al-Ajlan</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.S.</span> <span class="nlm-surname">Al Sultan</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Minhas</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Z.</span> <span class="nlm-surname">Assis</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.A.</span> <span class="nlm-surname">de Miquel</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Millán</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">L.</span> <span class="nlm-surname">San Román</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Tomassello</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.M.</span> <span class="nlm-surname">Demchuk</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">T.G.</span> <span class="nlm-surname">Jovin</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Cuadras</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Dávalos</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Goyal</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">B.K.</span> <span class="nlm-surname">Menon</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">107-110; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5463 </span></div>
  
  
  
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