Key result
Endovascular stroke outcome comparisons across centers or trials are flawed unless the denominator reflects all patients with proximal large-vessel occlusion in the population rather than only treated cases.
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Evaluating acute stroke endovascular interventions requires considering the total population of patients with proximal vessel occlusion as the denominator rather than only the subset selected for treatment, as strict imaging selection may inflate procedural success rates while reducing overall societal benefit.
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Mayank Goyal (2013) conducted an editorial in Acute ischemic stroke caused by large-vessel occlusion. Endovascular intra-arterial therapy and imaging-based patient selection was evaluated on Good clinical outcome (modified Rankin Scale ≤2). Endovascular stroke outcome comparisons across centers or trials are flawed unless the denominator reflects all patients with proximal large-vessel occlusion in the population rather than only treated cases.
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