Pedagogy and critical appraisal

 

Pedagogy topic : Multiple Myeloma 

Evidence based Medicine and Critical appraisal of the article :

Objective :

To investigate whether endovascular thrombectomy alone is noninferior to intravenous alteplase followed by endovascular thrombectomy for achieving functional independence at 90 days among patients with large vessel occlusion stroke.

Design :

Multicenter, randomized, noninferiority trial conducted at 33 stroke centers in China. Enrollment took place from May 20, 2018, to May 2, 2020. Patients were enrolled and followed up for 90 days (final follow-up was July 22, 2020).

Patients:

Patients (n = 234) were 18 years or older with proximal anterior circulation intracranial occlusion strokes within 4.5 hours from symptoms onset and eligible for intravenous thrombolysis.

Intervention: 

Patients were randomized to the endovascular thrombectomy alone as one arm and other arm as combined intravenous thrombolysis with IV alteplase and endovascular thrombectomy.

Comparision:

A total of 116 patients were randomized to the endovascular thrombectomy alone group and 118 patients to combined intravenous thrombolysis and endovascular thrombectomy group.

Outcome :

The primary end point was the proportion of patients achieving functional independence at 90 days (defined as score 0-2 on the modified Rankin Scale; range, 0 [no symptoms] to 6 [death]).

Result:

63 out of 116 patients in Endovascular thrombectomy group and 55 out of 118 patients in combined intravenous thrombolysis and Endovascular thrombectomy group achieved functional independence

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816099/