Impact of intravenous thrombolysis and ...
Type de document :
Article dans une revue scientifique: Article original
DOI :
PMID :
URL permanente :
Titre :
Impact of intravenous thrombolysis and emergent carotid stenting on reperfusion and clinical outcomes in acute stroke patients with tandem lesion treated with thrombectomy: a collaborative pooled analysis
Auteur(s) :
Gory, Benjamin [Auteur]
Haussen, Diogo C. [Auteur]
Piotin, Michel [Auteur]
Steglich-Arnholm, Henrik [Auteur]
Holtmannspotter, Markus [Auteur]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Kyheng, Maéva [Auteur]
Taschner, Christian [Auteur]
Eiden, Sebastian [Auteur]
Nogueira, Raul G. [Auteur]
Papanagiotou, Panagiotis [Auteur]
Boutchakova, Maria [Auteur]
Siddiqui, Adnan H. [Auteur]
Lapergue, Bertrand [Auteur]
Dorn, Franziska [Auteur]
Cognard, Christophe [Auteur]
Killer, Monika [Auteur]
Mangiafico, Salvatore [Auteur]
Ribo, Marc [Auteur]
Psychogios, Marios N. [Auteur]
Spiotta, Alejandro M. [Auteur]
Labeyrie, Marc Antoine [Auteur]
Biondi, Alessandra [Auteur]
Mazighi, Mikael [Auteur]
Turjman, Francis [Auteur]
Haussen, Diogo C. [Auteur]
Piotin, Michel [Auteur]
Steglich-Arnholm, Henrik [Auteur]
Holtmannspotter, Markus [Auteur]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Kyheng, Maéva [Auteur]
Taschner, Christian [Auteur]
Eiden, Sebastian [Auteur]
Nogueira, Raul G. [Auteur]
Papanagiotou, Panagiotis [Auteur]
Boutchakova, Maria [Auteur]
Siddiqui, Adnan H. [Auteur]
Lapergue, Bertrand [Auteur]
Dorn, Franziska [Auteur]
Cognard, Christophe [Auteur]
Killer, Monika [Auteur]
Mangiafico, Salvatore [Auteur]
Ribo, Marc [Auteur]
Psychogios, Marios N. [Auteur]
Spiotta, Alejandro M. [Auteur]
Labeyrie, Marc Antoine [Auteur]
Biondi, Alessandra [Auteur]
Mazighi, Mikael [Auteur]
Turjman, Francis [Auteur]
Titre de la revue :
European journal of neurology
Nom court de la revue :
Eur. J. Neurol.
Date de publication :
2018-03-25
ISSN :
1468-1331
Mot(s)-clé(s) en anglais :
medication
stroke
arterial dissection
cerebral infarction
endovascular procedures
intensive care
stroke
arterial dissection
cerebral infarction
endovascular procedures
intensive care
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Tandem anterior circulation lesions in the setting of acute ischemic stroke (AIS) are a complex endovascular situation that has not been specifically addressed in trials. We determined the predictors of successful reperfusion ...
Lire la suite >Tandem anterior circulation lesions in the setting of acute ischemic stroke (AIS) are a complex endovascular situation that has not been specifically addressed in trials. We determined the predictors of successful reperfusion and good clinical outcome at 90 days after mechanical thrombectomy (MT) in patients with AIS with tandem lesions in a pooled collaborative study. This was a retrospective analysis of consecutive patients presenting to 18 comprehensive stroke centers with AIS due to tandem lesion of the anterior circulation who underwent MT. A total of 395 patients were included. Successful reperfusion (modified thrombolysis in cerebral infarction score 2b-3) was achieved in 76.7%. At 90 days, 52.2% achieved a good outcome (modified Rankin Scale score 0-2), 13.8% suffered a parenchymal hematoma and 13.2% were dead. Lower National Institutes of Health Stroke Scale score [odds ratio (OR), 1.26; 95% confidence intervals (CI), 1.07-1.48, P = 0.004], Alberta Stroke Program Early CT Score ≥7 (OR, 2.00; 95% CI, 1.07-3.43, P = 0.011), intravenous thrombolysis (OR, 1.47; 95% CI, 1.01-2.12, P = 0.042) and stenting of the extracranial carotid lesion (OR, 1.63; 95% CI, 1.04-2;53, P = 0.030) were independently associated with successful reperfusion. Lower age (OR, 1.58; 95% CI, 1.26-1.97, P < 0.001), absence of hypercholesterolemia (OR, 1.77; 95% CI, 1.10-2.84, P = 0.018), lower National Institutes of Health Stroke Scale scores (OR, 2.04; 95% CI, 1.53-2.72, P < 0.001), Alberta Stroke Program Early CT Score ≥7 (OR, 2.75; 95% CI, 1.24-6.10, P = 0.013) and proximal middle cerebral artery occlusion (OR, 1.59; 95% CI, 1.03-2.44, P = 0.035) independently predicted a good 90-day outcome. Intravenous thrombolysis and emergent stenting of the extracranial carotid lesion were predictors of a successful reperfusion after MT of patients with AIS with tandem lesion of the anterior circulation.Lire moins >
Lire la suite >Tandem anterior circulation lesions in the setting of acute ischemic stroke (AIS) are a complex endovascular situation that has not been specifically addressed in trials. We determined the predictors of successful reperfusion and good clinical outcome at 90 days after mechanical thrombectomy (MT) in patients with AIS with tandem lesions in a pooled collaborative study. This was a retrospective analysis of consecutive patients presenting to 18 comprehensive stroke centers with AIS due to tandem lesion of the anterior circulation who underwent MT. A total of 395 patients were included. Successful reperfusion (modified thrombolysis in cerebral infarction score 2b-3) was achieved in 76.7%. At 90 days, 52.2% achieved a good outcome (modified Rankin Scale score 0-2), 13.8% suffered a parenchymal hematoma and 13.2% were dead. Lower National Institutes of Health Stroke Scale score [odds ratio (OR), 1.26; 95% confidence intervals (CI), 1.07-1.48, P = 0.004], Alberta Stroke Program Early CT Score ≥7 (OR, 2.00; 95% CI, 1.07-3.43, P = 0.011), intravenous thrombolysis (OR, 1.47; 95% CI, 1.01-2.12, P = 0.042) and stenting of the extracranial carotid lesion (OR, 1.63; 95% CI, 1.04-2;53, P = 0.030) were independently associated with successful reperfusion. Lower age (OR, 1.58; 95% CI, 1.26-1.97, P < 0.001), absence of hypercholesterolemia (OR, 1.77; 95% CI, 1.10-2.84, P = 0.018), lower National Institutes of Health Stroke Scale scores (OR, 2.04; 95% CI, 1.53-2.72, P < 0.001), Alberta Stroke Program Early CT Score ≥7 (OR, 2.75; 95% CI, 1.24-6.10, P = 0.013) and proximal middle cerebral artery occlusion (OR, 1.59; 95% CI, 1.03-2.44, P = 0.035) independently predicted a good 90-day outcome. Intravenous thrombolysis and emergent stenting of the extracranial carotid lesion were predictors of a successful reperfusion after MT of patients with AIS with tandem lesion of the anterior circulation.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
CHU Lille
Université de Lille
Université de Lille
Date de dépôt :
2019-12-09T18:18:55Z