TY - JOUR
T1 - Two-year clinical follow-up of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN)
T2 - Design and statistical analysis plan of the extended follow-up study
AU - van den Berg, Lucie A.
AU - Dijkgraaf, Marcel G.W.
AU - Berkhemer, Olvert A.
AU - Fransen, Puck SS
AU - Beumer, Debbie
AU - Lingsma, Hester F.
AU - Majoie, Charles B.L.M.
AU - Dippel, Diederik W.J.
AU - van der Lugt, Aad J.
AU - van Oostenbrugge, Robert J.
AU - van Zwam, Wim H.
AU - Roos, Yvo B.W.E.M.
AU - Lingsma, Hester F.
AU - Yoo, Albert J.
AU - Schonewille, Wouter J.
AU - Albert Vos, Jan
AU - Nederkoorn, Paul H.J.
AU - Wermer, Marieke J.H.
AU - van Walderveen, Marianne AA
AU - Staals, Julie
AU - Hofmeijer, Jeannette
AU - van Oostayen, Jacques A.
AU - à Nijeholt, Geert J.Lycklama
AU - Boiten, Jelis
AU - Brouwer, Patrick A.
AU - Emmer, Bart J.
AU - de Bruijn, Sebastiaan F.
AU - van Dijk, Lukas C.
AU - Jaap Kappelle, L.
AU - Lo, Rob H.
AU - van Dijk, Ewoud J.
AU - de Vries, Joost
AU - de Kort, Paul L.M.
AU - van Rooij, Willem Jan
AU - van den Berg, Jan S.P.
AU - van Hasselt, Boudewijn A.A.M.
AU - Aerden, Leo A.M.
AU - Dallinga, René J.
AU - Visser, Marieke C.
AU - Bot, Joseph C.J.
AU - Vroomen, Patrick C.
AU - Eshghi, Omid
AU - Schreuder, Tobien H.C.M.L.
AU - Heijboer, Roel J.J.
AU - Keizer, Koos
AU - Tielbeek, Alexander V.
AU - den Hertog, Heleen M.
AU - Gerrits, Dick G
AU - van den Berg-Vos, Renske M.
AU - Karas, Giorgos B.
AU - for the MR CLEAN invesigators
PY - 2016/11/22
Y1 - 2016/11/22
N2 - Background: MR CLEAN was the first randomized trial to demonstrate the short-term clinical effectiveness of endovascular treatment in patients with acute ischemic stroke caused by large vessel occlusion in the anterior circulation. Several other trials confirmed that endovascular treatment improves clinical outcome at three months. However, limited data are available on long-term clinical outcome. We aimed to estimate the effect of endovascular treatment on functional outcome at two-year follow-up in patients with acute ischemic stroke. Secondly, we aimed to assess the effect of endovascular treatment on major vascular events and mortality during two years of follow-up. Methods: MR CLEAN is a multicenter clinical trial with randomized treatment allocation, open-label treatment, and blinded endpoint evaluation. Patients included were 18 years or older with acute ischemic stroke caused by a proven anterior proximal artery occlusion who could be treated within six hours after stroke onset. The intervention contrast was endovascular treatment and usual care versus no endovascular treatment and usual care. The current study extended the follow-up duration from three months to two years. The primary outcome is the score on the modified Rankin scale at two years. Secondary outcomes include all-cause mortality and the occurrence of major vascular events within two years of follow-up. Discussion: The results of our study provide information on the long-term clinical effectiveness of endovascular treatment, which may have implications for individual treatment decisions and estimates of cost-effectiveness. Trial registration:NTR1804. Registered on 7 May 2009; ISRCTN10888758. Registered on 24 July 2012 (main MR CLEAN trial); NTR5073. Registered on 26 February 2015 (extended follow-up study).
AB - Background: MR CLEAN was the first randomized trial to demonstrate the short-term clinical effectiveness of endovascular treatment in patients with acute ischemic stroke caused by large vessel occlusion in the anterior circulation. Several other trials confirmed that endovascular treatment improves clinical outcome at three months. However, limited data are available on long-term clinical outcome. We aimed to estimate the effect of endovascular treatment on functional outcome at two-year follow-up in patients with acute ischemic stroke. Secondly, we aimed to assess the effect of endovascular treatment on major vascular events and mortality during two years of follow-up. Methods: MR CLEAN is a multicenter clinical trial with randomized treatment allocation, open-label treatment, and blinded endpoint evaluation. Patients included were 18 years or older with acute ischemic stroke caused by a proven anterior proximal artery occlusion who could be treated within six hours after stroke onset. The intervention contrast was endovascular treatment and usual care versus no endovascular treatment and usual care. The current study extended the follow-up duration from three months to two years. The primary outcome is the score on the modified Rankin scale at two years. Secondary outcomes include all-cause mortality and the occurrence of major vascular events within two years of follow-up. Discussion: The results of our study provide information on the long-term clinical effectiveness of endovascular treatment, which may have implications for individual treatment decisions and estimates of cost-effectiveness. Trial registration:NTR1804. Registered on 7 May 2009; ISRCTN10888758. Registered on 24 July 2012 (main MR CLEAN trial); NTR5073. Registered on 26 February 2015 (extended follow-up study).
KW - Acute ischemic stroke
KW - Endovascular treatment
KW - Intravenous thrombolysis
KW - Mechanical thrombectomy
KW - Randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85001018485&partnerID=8YFLogxK
U2 - 10.1186/s13063-016-1669-6
DO - 10.1186/s13063-016-1669-6
M3 - Article
C2 - 27876083
AN - SCOPUS:85001018485
SN - 1745-6215
VL - 17
JO - Trials
JF - Trials
IS - 1
M1 - 555
ER -
