{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T21:42:29Z","timestamp":1767994949203,"version":"3.49.0"},"reference-count":0,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intervent Neurol"],"published-print":{"date-parts":[[2018]]},"abstract":"<b><i>Background and Aims:<\/i><\/b> Patients with emergent large-vessel occlusion (ELVO) that present earlier than 4 h from onset are usually treated with bridging systemic thrombolysis followed by endovascular thrombectomy (EVT). Whether direct EVT (dEVT) could improve the chances of favorable outcome remains unknown. <b><i>Methods:<\/i><\/b> Consecutively, prospectively enrolled patients with ELVO presenting within 4 h of onset were entered into a National Acute Stroke Registry of patients undergoing revascularization. Patients treated with bridging were compared to those treated with dEVT. Excellent outcome was defined as having a modified Rankin Scale score \u22641 at 90 days following stroke. <b><i>Results:<\/i><\/b> Out of 392 patients that underwent thrombectomy, 270 (68%) presented within 4 h and were included. Of those, 159 (59%) underwent bridging and 111 (41%) underwent dEVT. Atrial fibrillation and congestive heart failure were more common in the dEVT group (43 vs. 30%, <i>p<\/i> = 0.04 and 20 vs. 8%, <i>p<\/i> = 0.009, respectively), but other risk factors, demographics, stroke severity and subtypes as well as baseline vessel patency state and time metrics did not differ. Excellent target vessel recanalization defined as TICI 3 (thrombolysis in cerebral infarction score) was more common in the dEVT group (75 vs. 61%, <i>p<\/i> = 0.03), but in-hospital mortality, discharge destinations, short- and long-term excellent outcome rates did not differ. On multivariate regression analysis, treatment modality did not significantly modify the chances of excellent outcome at discharge (OR 0.7; 95% CI 0.3\u20131.5) or at 3 months (OR 0.78 95% CI 0.4\u20131.4). <b><i>Conclusions:<\/i><\/b> The chances of attaining excellent functional outcomes are similar in ELVO patients undergoing dEVT or bridging.<\/jats:p>","DOI":"10.1159\/000489575","type":"journal-article","created":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T21:01:30Z","timestamp":1530738090000},"page":"403-412","source":"Crossref","is-referenced-by-count":10,"title":["Direct Thrombectomy versus Bridging for Patients with Emergent Large-Vessel Occlusions"],"prefix":"10.1159","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4794-0334","authenticated-orcid":false,"given":"Ronen\u00a0R.","family":"Leker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose\u00a0E.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Tanne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Orion","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Telman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Raphaeli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Amsalem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan\u00a0Y.","family":"Streifler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hen","family":"Hallevi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavel","family":"Gavriliuc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natan\u00a0M.","family":"Bornstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anat","family":"Horev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nour\u00a0Eddine","family":"Yaghmour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"NASIS-REVASC\u00a0Study\u00a0Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2018,7,4]]},"container-title":["Interventional Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/489575","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/489575","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:30:27Z","timestamp":1745425827000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000489575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,10,9]]},"published-print":{"date-parts":[[2018,10,16]]}},"URL":"https:\/\/doi.org\/10.1159\/000489575","archive":["Portico"],"relation":{},"ISSN":["1664-9737","1664-5545"],"issn-type":[{"value":"1664-9737","type":"print"},{"value":"1664-5545","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018]]}}}