Endovascular decision-making based on patient neurologic status, stratified by site of occlusion
| Physicians’ Responses to the Question Regarding EVT in Presented MeVO Cases | RR (95%CI)a | ||||
|---|---|---|---|---|---|
| EVT Yes | Wait for 10 Min and Repeat DSA | Wake Up the Patient for Reassessment | EVT No | ||
| Decision to treat based on occlusion site | |||||
| Occlusion site (No.) (%) | |||||
| Posterior M3/4 MCA | 311 (28.3) | 189 (17.2) | 22 (2.0) | 576 (52.5) | Ref. |
| Anterior M2/3 MCA | 816 (74.3) | 157 (14.3) | 16 (1.5) | 109 (9.9) | 2.62 (2.27–3.03)b |
| A3 ACA | 655 (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 improvement | 299 (81.7) | 42 (11.2) | NA | 25 (6.8) | Ref. |
| Patient improved | 245 (66.9) | 70 (19.1) | NA | 51 (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 improvement | 111 (30.3) | 69 (18.9) | NA | 186 (50.8) | Ref. |
| Patient improved | 89 (24.3) | 66 (18.0) | NA | 211 (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 improvement | 216 (59.0) | 67 (18.3) | NA | 83 (22.7) | Ref. |
| Patient improved | 214 (58.5) | 67 (18.3) | NA | 85 (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.