Impact of prodromal symptoms on the prognosis ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Impact of prodromal symptoms on the prognosis of patients with basilar artery occlusion treated with mechanical thrombectomy
Author(s) :
Accettone, T. [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Personnic, Thomas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bretzner, Martin [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Behal, Helene [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Cordonnier, Charlotte [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Henon, Hilde [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Puy, Laurent [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Personnic, Thomas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bretzner, Martin [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Behal, Helene [Auteur]

Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Cordonnier, Charlotte [Auteur]

Lille Neurosciences & Cognition (LilNCog) - U 1172
Henon, Hilde [Auteur]

Lille Neurosciences & Cognition (LilNCog) - U 1172
Puy, Laurent [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Journal title :
European Stroke Journal
Abbreviated title :
Eur Stroke J
Pages :
23969873241234844
Publication date :
2024-02-27
ISSN :
2396-9881
English keyword(s) :
Ischemic stroke
basilar artery occlusion
mechanical thrombectomy
prodromal symptoms
basilar artery occlusion
mechanical thrombectomy
prodromal symptoms
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Introduction:
Even with reperfusion therapies, the prognosis of patients with basilar artery occlusion (BAO) related stroke remains poor. We aimed to test the hypothesis that the presence of prodromal symptoms, an easily ...
Show more >Introduction: Even with reperfusion therapies, the prognosis of patients with basilar artery occlusion (BAO) related stroke remains poor. We aimed to test the hypothesis that the presence of prodromal symptoms, an easily available anamnestic data, is a key determinant of poor functional outcome. Patients and methods: Data from patients with BAO treated in Lille, France, with mechanical thrombectomy (MT) between 2015 and 2021 were prospectively collected. The presence of prodromal symptoms was defined by previous transient neurological deficit or gradual progressive clinical worsening preceding a secondary sudden clinical worsening. We compared the characteristics of patients with and without prodromal symptoms. We built multivariate logistic regression models to study the association between the presence of prodromal symptoms and functional (mRS 0–3 and mortality), and procedural (successful recanalization and early reocclusion) outcomes. Results: Among the 180 patients, 63 (35%) had prodromal symptoms, most frequently a vertigo. Large artery atherosclerosis was the predominant cause of stroke (41.3%). The presence of prodromal symptoms was an independent predictor of worse 90-day functional outcome (mRS 0–3: 25.4% vs 47.0%, odds ratio (OR) 0.39; 95% confidence interval (CI) 0.16–0.86) and 90-day mortality (OR 2.17; 95% CI 1.02–4.65). Despite similar successful recanalization rate, the proportion of early basilar artery reocclusion was higher in patients with prodromal symptoms (23.8% vs 5.6%, p = 0.002). Discussion and conclusion: More than one third of BAO patients treated with MT had prodromal symptoms, especially patients with large-artery atherosclerosis. Clinicians should systematically screen for prodromal symptoms given the poor related functional outcome and increased risk of early basilar artery reocclusion.Show less >
Show more >Introduction: Even with reperfusion therapies, the prognosis of patients with basilar artery occlusion (BAO) related stroke remains poor. We aimed to test the hypothesis that the presence of prodromal symptoms, an easily available anamnestic data, is a key determinant of poor functional outcome. Patients and methods: Data from patients with BAO treated in Lille, France, with mechanical thrombectomy (MT) between 2015 and 2021 were prospectively collected. The presence of prodromal symptoms was defined by previous transient neurological deficit or gradual progressive clinical worsening preceding a secondary sudden clinical worsening. We compared the characteristics of patients with and without prodromal symptoms. We built multivariate logistic regression models to study the association between the presence of prodromal symptoms and functional (mRS 0–3 and mortality), and procedural (successful recanalization and early reocclusion) outcomes. Results: Among the 180 patients, 63 (35%) had prodromal symptoms, most frequently a vertigo. Large artery atherosclerosis was the predominant cause of stroke (41.3%). The presence of prodromal symptoms was an independent predictor of worse 90-day functional outcome (mRS 0–3: 25.4% vs 47.0%, odds ratio (OR) 0.39; 95% confidence interval (CI) 0.16–0.86) and 90-day mortality (OR 2.17; 95% CI 1.02–4.65). Despite similar successful recanalization rate, the proportion of early basilar artery reocclusion was higher in patients with prodromal symptoms (23.8% vs 5.6%, p = 0.002). Discussion and conclusion: More than one third of BAO patients treated with MT had prodromal symptoms, especially patients with large-artery atherosclerosis. Clinicians should systematically screen for prodromal symptoms given the poor related functional outcome and increased risk of early basilar artery reocclusion.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
Inserm
CHU Lille
Inserm
CHU Lille
Collections :
Submission date :
2024-03-20T22:04:25Z
2024-09-02T14:52:58Z
2024-09-02T14:52:58Z