Predicting Outcomes in the Era of Endovascular Therapy.

Abstract

See related article, p 105. Endovascular thrombectomy (ET) is a monumental step forward for the treatment of acute ischemic stroke secondary to large vessel occlusion. However, in the 5 clinical trials that made ET standard of care for acute stroke, despite high rates of TICI (thrombolysis in cerebral infarction) ≥2b recanalization, good outcome (assessed by mRS [modified Rankin Scale] ≤2 at 90 days) was achieved in 33% to 71% of patients.1–5 Improving outcomes can be achieved by better prehospital screening, improvements in systems of care, newer generation devices, or combination of Neuroprotection with ET. However, before any new treatment is adopted in clinical practice, it will need to be tested in the setting of a clinical trial. One of the major challenges of any randomized controlled trial is the need to have effective instruments to predict outcomes and optimize the number of patients enrolled. For this purpose, several stroke scales that can predict …