AHA/ISC

International Stroke Conference: Lying flat equals better outcomes for stroke thrombectomy candidates

February 15, 2024

According to data presented in Phoenix earlier this month, placing patients with an acute ischemic stroke cause by large-vessel occlusion (LVO) flat on their bed as they await mechanical thrombectomy is a simple way to improve short-term outcomes. The ZODIAC trial found that the approach was safe and imparts clinical stability and improvement in LVO thrombectomy candidates.

• The study was conducted at 12 U.S. hospitals and included 92 patients (mean age, 66 years) who had an LVO stroke and a treatment plan that included mechanical thrombectomy.
• While patients were still flat, investigators calculated the initial NIHSS score and administered thrombolytic therapy to those who were eligible. The patients were then randomized immediately to remaining in a zero-degree position or being placed at a 30-degree angle, with those positions maintained until they were taken for thrombectomy. The final NIHSS score calculation occurred before the patient was moved to the catheterization table.
• The primary outcome was early neurological deterioration prior to thrombectomy, with a significant advantage for zero-degree head positioning. The difference between groups translated to a number needed to harm (NNH) with 30-degree positioning of 1.88.

Source:

Alexandrov, AW. et al. (2024, February 7). American Stroke Association: International Stroke Conference (ISC). Final results of the zero degree head positioning acute large vessel ischemic stroke (ZODIAC) multicenter clinical trial. Presented at: ISC 2024. Phoenix, AZ. https://www.abstractsonline.com/pp8/#!/10942/presentation/3760