TICI-RANKIN mismatch: Poor clinical outcome ...
Document type :
Article dans une revue scientifique: Article original
PMID :
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Title :
TICI-RANKIN mismatch: Poor clinical outcome despite complete endovascular reperfusion in the ETIS Registry.
Author(s) :
Dong, A. [Auteur]
Sorbonne Université - Faculté de Santé [SU FdS]
Centre Hospitalier de Versailles André Mignot [CHV]
Maier, B. [Auteur]
Hôpital Fondation Adolphe de Rothschild = Adolphe de Rothschild Foundation Hospital
Guillon, B. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Preterre, C. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
De Gaalon, S. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Gory, B. [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Richard, S. [Auteur]
Centre Hospitalier Universitaire de Nancy [CHU Nancy]
Kaminsky, A. L. [Auteur]
Centre Hospitalier Universitaire de Nancy [CHU Nancy]
Tracol, C. [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Eugene, F. [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Sibon, I. [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Tourdias, T. [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Smajda, S. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Marnat, G. [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Bourcier, R. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Gaillard, N. [Auteur]
CHU Montpellier = Montpellier University Hospital
Consoli, A. [Auteur]
Hôpital Foch [Suresnes]
Kyheng, Maéva [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Labreuche, Julien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Lapergue, B. [Auteur]
Hôpital Foch [Suresnes]
Pico, F. [Auteur]
Centre Hospitalier de Versailles André Mignot [CHV]
Sorbonne Université - Faculté de Santé [SU FdS]
Centre Hospitalier de Versailles André Mignot [CHV]
Maier, B. [Auteur]
Hôpital Fondation Adolphe de Rothschild = Adolphe de Rothschild Foundation Hospital
Guillon, B. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Preterre, C. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
De Gaalon, S. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Gory, B. [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Richard, S. [Auteur]
Centre Hospitalier Universitaire de Nancy [CHU Nancy]
Kaminsky, A. L. [Auteur]
Centre Hospitalier Universitaire de Nancy [CHU Nancy]
Tracol, C. [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Eugene, F. [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Sibon, I. [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Tourdias, T. [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Smajda, S. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Marnat, G. [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Bourcier, R. [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Gaillard, N. [Auteur]
CHU Montpellier = Montpellier University Hospital
Consoli, A. [Auteur]
Hôpital Foch [Suresnes]
Kyheng, Maéva [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Labreuche, Julien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Lapergue, B. [Auteur]
Hôpital Foch [Suresnes]
Pico, F. [Auteur]
Centre Hospitalier de Versailles André Mignot [CHV]
Journal title :
Revue Neurologique
Abbreviated title :
Rev Neurol (Paris)
Publication date :
2023-02-23
ISSN :
0035-3787
English keyword(s) :
Endovascular treatment
Poor outcome
Prognosis
Predictors
Poor outcome
Prognosis
Predictors
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Introduction
Endovascular treatment (EVT) is a well-established technic for acute ischemic stroke, but despite a high recanalization rate of near 80%, at 3 months roughly 50% of patients have a poor functional outcome ...
Show more >Introduction Endovascular treatment (EVT) is a well-established technic for acute ischemic stroke, but despite a high recanalization rate of near 80%, at 3 months roughly 50% of patients have a poor functional outcome with a modified Rankin score (mRS) ≥3. The aim of this study was to determine predictive factors of poor functional outcomes in patients with complete recanalization after EVT, defined as modified thrombolysis in cerebral infarction (mTICI) 3. Patients and methods This retrospective analysis based on the prospective multicenter ETIS registry (endovascular treatment in ischemic stroke) in France included 795 patients from January 2015 and November 2019 with acute ischemic stroke due to anterior circulation occlusion and prestroke mRS 0-1, treated with EVT and who achieved complete recanalization. Univariate and multivariate logistic regression models were used to identify predictive factors of poor functional outcome. Results 365 patients (46%) showed a poor functional outcome (mRS > 2). In backward-stepwise logistic regression analysis, poor functional outcome was independently associated with older age (OR per 10-year increase, 1.51; 95%CI, 1.30 to 1.75), higher admission NIHSS (OR per 1 point increase, 1.28; 95%CI, 1.21 to 1.34), absence of prior intravenous thrombolysis (OR, 0.59; 95%CI, 0.39 to 0.90), and an unfavorable 24-hour NIHSS change (24h-baseline) (OR, 0.82; 95%CI, 0.79 to 0.87). We calculated that patients whose 24 h NIHSS decreased by less than 5 points are more at risk of a poor outcome, with a sensitivity and a specificity of 65.0%. Conclusion Despite complete reperfusion after EVT, half of patients had a poor clinical outcome. These patients, who were mainly older with a high initial NIHSS and an unfavorable post-EVT 24 h NIHSS change, could represent a target population for early neurorepair and neurorestorative strategies.Show less >
Show more >Introduction Endovascular treatment (EVT) is a well-established technic for acute ischemic stroke, but despite a high recanalization rate of near 80%, at 3 months roughly 50% of patients have a poor functional outcome with a modified Rankin score (mRS) ≥3. The aim of this study was to determine predictive factors of poor functional outcomes in patients with complete recanalization after EVT, defined as modified thrombolysis in cerebral infarction (mTICI) 3. Patients and methods This retrospective analysis based on the prospective multicenter ETIS registry (endovascular treatment in ischemic stroke) in France included 795 patients from January 2015 and November 2019 with acute ischemic stroke due to anterior circulation occlusion and prestroke mRS 0-1, treated with EVT and who achieved complete recanalization. Univariate and multivariate logistic regression models were used to identify predictive factors of poor functional outcome. Results 365 patients (46%) showed a poor functional outcome (mRS > 2). In backward-stepwise logistic regression analysis, poor functional outcome was independently associated with older age (OR per 10-year increase, 1.51; 95%CI, 1.30 to 1.75), higher admission NIHSS (OR per 1 point increase, 1.28; 95%CI, 1.21 to 1.34), absence of prior intravenous thrombolysis (OR, 0.59; 95%CI, 0.39 to 0.90), and an unfavorable 24-hour NIHSS change (24h-baseline) (OR, 0.82; 95%CI, 0.79 to 0.87). We calculated that patients whose 24 h NIHSS decreased by less than 5 points are more at risk of a poor outcome, with a sensitivity and a specificity of 65.0%. Conclusion Despite complete reperfusion after EVT, half of patients had a poor clinical outcome. These patients, who were mainly older with a high initial NIHSS and an unfavorable post-EVT 24 h NIHSS change, could represent a target population for early neurorepair and neurorestorative strategies.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Submission date :
2023-11-15T02:26:26Z
2024-04-05T08:18:56Z
2024-04-05T08:18:56Z