Titre :

Susceptibility vessel sign in the aster trial: higher recanalization rate and more favourable clinical outcome after first line stent retriever compared to contact aspiration

Auteur(s) :

Bourcier, Romain [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Mazighi, Mikael [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Fahed, Robert [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Blanc, Raphael [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Gory, Benjamin [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Marnat, Gaultier [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Saleme, Suzana [Auteur]
Service de Neuroradiologie interventionnelle [CHU Limoges]
Costalat, Vincent [Auteur]
Université de Montpellier [UM]
Bracard, Serge [Auteur]
Université Henri Poincaré - Nancy 1 [UHP]
Desal, Hubert [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Consoli, Arturo [Auteur]
Université de Versailles Saint-Quentin-en-Yvelines [UVSQ]
Piotin, Michel [Auteur]
Fondation Ophtalmologique Adolphe de Rotschild
Lapergue, Bertrand [Auteur]
Université de Versailles Saint-Quentin-en-Yvelines [UVSQ]

Titre de la revue :

Journal of stroke

Nom court de la revue :

J Stroke

Numéro :

20

Pagination :

268-276

Date de publication :

2018-06-29

ISSN :

2287-6391

Mot(s)-clé(s) en anglais :

Thrombectomy
Thrombosis
Retrieval device
Aspiration catheter

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Background and Purpose In the Aspiration vs. Stent Retriever for Successful Revascularization (ASTER) trial, which evaluated contact aspiration (CA) versus stent retriever (SR) use as first-line technique, the impact of ...
Lire la suite >Background and Purpose In the Aspiration vs. Stent Retriever for Successful Revascularization (ASTER) trial, which evaluated contact aspiration (CA) versus stent retriever (SR) use as first-line technique, the impact of the susceptibility vessel sign (SVS) on magnetic resonance imaging (MRI) was studied to determine its influence on trial results. Methods We included patients having undergone CA or SR for M1 or M2 occlusions, who were screened by MRI with T2* gradient recalled echo. Occlusions were classified as SVS (+) or SVS (-) in each randomization arm. Modified thrombolysis in cerebral infarction (mTICI) 2b, 2c, or 3 revascularization rates were recorded and clinical outcomes assessed by the overall distribution of modified Rankin scale (mRS) at 90 days. Results Among the 202 patients included, 143 patients were SVS (+) (70.8%; 95% confidence interval [CI], 64.5% to 77.1%). Overall, there was no difference in angiographic and clinical outcomes according to SVS status. However, compared to SR, CA achieved a lower mTICI 2c/3 rate in SVS (+) patients (risk ratio [RR] for CA vs. SR, 0.60; 95% CI, 0.51 to 0.71) but not in SVS (-) (RR, 1.11; 95% CI, 0.69 to 1.77; P for interaction=0.018). A significant heterogeneity in favor of superiority of first-line SR strategy in SVS (+) patients was also found regarding the overall mRS distribution (common odds ratio for CA vs. SR, 0.40 vs. 1.32; 95% CI, 0.21 to 0.74 in SVS (+) vs. 95% CI, 0.51 to 3.35 in SVS (-); P for interaction=0.038). Conclusions As a first line strategy, SR achieved higher recanalization rates and a more favourable clinical outcome at 3 months compared to CA when MRI shows SVS within the thrombus.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2019-12-09T16:48:58Z
2020-05-19T08:24:40Z