Mechanical Thrombectomy in Ischemic Stroke With a Medium or Distal Arterial Occlusion: The DISCOUNT Randomized Clinical Trial.
Frédéric Clarençon, Fouzi Bala, Amandine Baptiste et al.
✦ AI-curated · Sources linked
In 30 seconds
The DISCOUNT randomized clinical trial evaluated the efficacy of thrombectomy plus medical treatment versus medical treatment alone in patients with acute ischemic stroke due to medium or distal vessel occlusions. Conducted at 22 centers in France, the trial was halted for futility after enrolling 244 patients. At 3 months, 62% of the thrombectomy group achieved a good clinical outcome compared to 68% in the control group, with no significant difference (odds ratio, 0.73).
Key findings
- 62% of the thrombectomy group had a good clinical outcome at 3 months compared to 68% in the control group.
- The incidence of symptomatic intracranial hemorrhages was higher in the thrombectomy group (11% vs 3%).
- Subarachnoid hemorrhages occurred more frequently in the thrombectomy group (13% vs 2%).
- Mortality rates were similar between groups (6% vs 8%; P=0.49).
Why it matters
This study highlights the limited benefit of thrombectomy in patients with medium or distal vessel occlusions, raising concerns about the associated risks of hemorrhagic complications. Clinicians should carefully consider these findings when evaluating treatment options for acute ischemic stroke.