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Endovascular decision-making based on patient neurologic status, stratified by site of occlusion
Physicians’ Responses to the Question Regarding EVT in Presented MeVO CasesRR (95%CI)a
EVT YesWait for 10 Min and Repeat DSAWake Up the Patient for ReassessmentEVT No
Decision to treat based on occlusion site
 Occlusion site (No.) (%)
  Posterior M3/4 MCA311 (28.3)189 (17.2)22 (2.0)576 (52.5)Ref.
  Anterior M2/3 MCA816 (74.3)157 (14.3)16 (1.5)109 (9.9)2.62 (2.27–3.03)b
  A3 ACA655 (59.7)190 (17.3)15 (1.4)238 (21.7)2.11 (1.83–2.42)b
Decision to treat based on occlusion site and neurologic status
 Anterior M2/3 MCA (No.) (%)
  No improvement299 (81.7)42 (11.2)NA25 (6.8)Ref.
  Patient improved245 (66.9)70 (19.1)NA51 (13.9)0.82 (0.77–0.87)b
  Unknown (GA)272 (74.3)45 (12.3)16 (4.4)33 (9.0)0.91 (0.87–0.95)b
 Posterior M3/4 MCA (No.) (%)
  No improvement111 (30.3)69 (18.9)NA186 (50.8)Ref.
  Patient improved89 (24.3)66 (18.0)NA211 (57.7)0.80 (0.70–0.92)b
  Unknown (GA)111 (30.3)54 (14.8)22 (6.0)179 (48.9)1.00 (0.90–1.11)
 A3 ACA (No.) (%)
  No improvement216 (59.0)67 (18.3)NA83 (22.7)Ref.
  Patient improved214 (58.5)67 (18.3)NA85 (23.2)0.99 (0.92–1.07)
  Unknown (GA)225 (61.5)56 (15.3)15 (4.1)70 (19.1)1.04 (0.99–1.10)
  • Note:—GA indicates general anesthesia; NA, not applicable; Ref., reference; ACA, anterior cerebral artery; Min, minutes.
  • ↵aResponses to “Wait for 10 minutes and repeat DSA to look for persistent occlusion” and “Wake up the patient for reassessment” (if applicable) were included in the “No EVT” category to calculate risk ratios. Data in columns 2–5 represent the responses of physicians to a survey question “Should the presented MeVO be treated endovascularly?”
  • ↵b P value < .05.