Title :

Influence of prior intravenous thrombolysis in patients treated with mechanical thrombectomy for M2 occlusions: insight from the Endovascular Treatment in Ischemic Stroke (ETIS) registry.

Author(s) :

Le Floch, Agathe [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Clarençon, Frédéric [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Rouchaud, Aymeric [Auteur]
Service de Neuroradiologie interventionnelle [CHU Limoges]
XLIM [XLIM]
Kyheng, MaÉva [Auteur]
Service de Biostatistiques [CHRU Lille]
Labreuche, Julien [Auteur]
Service de Biostatistiques [CHRU Lille]
Sibon, Igor [Auteur]
Service de neurologie [Bordeaux]
Boulouis, Grégoire [Auteur]
CHU Trousseau [Tours]
Gory, Benjamin [Auteur]
Service de neurologie [CHRU Nancy]
Richard, Sebastien [Auteur]
Service de neurologie [CHRU Nancy]
Caroff, Jildaz [Auteur]
Service de neurologie [Le Kremlin Bicêtre]
Blanc, Raphaël [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Seners, Pierre [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Eker, Omer F. [Auteur]

Cho, Tae-Hee [Auteur]

Consoli, Arturo [Auteur]
Service de neuroradiologie [Suresnes]
Bourcier, Romain [Auteur]
Service de neurologie [Nantes]
Guillon, Benoit [Auteur]
Service de neurologie [Nantes]
Dargazanli, Cyril [Auteur]
Département de Neuroradiologie[Montpellier]
Arquizan, Caroline [Auteur]
Département de Neurologie [Hôpital Gui de Chauliac - CHU Montpellier]
Denier, Christian [Auteur]
Service de neurologie [Le Kremlin Bicêtre]
Eugene, François [Auteur]
Département de Radiologie [CHU de Rennes]
Vannier, Stephane [Auteur]
Service de Neurologie [CHU Rennes]
Gentric, Jean-Christophe [Auteur]
Service de Neuroradiologie [Brest]
Gauberti, Maxime [Auteur]
Départment de Neuroradiologie [CHU Caen]
Naggara, Olivier [Auteur]
Service de neuroradiologie [Paris]
Rosso, Charlotte [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Turc, Guillaume [Auteur]
Service de Neurologie [CH Saint-Anne]
Ozkul-Wermester, Ozlem [Auteur]
Service de neurologie [Rouen]
Cognard, Christophe [Auteur]
Service Neuroradiologie Diagnostique et Thérapeutique [CHU Toulouse]
Albucher, Jean-François [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Timsit, Serge [Auteur]
Service de Neurologie [Brest]
Bourdain, Frédéric [Auteur]
Centre Hospitalier de la Côte Basque [CHCB]
Neurologie - Côte Basque
Le Bras, Anthony [Auteur]
Centre hospitalier Bretagne Atlantique (Morbihan) [CHBA]
Richter, Sebastian [Auteur]
Centre hospitalier de Pau
Moulin, Solène [Auteur]
Service de neurologie [Reims]
Pop, Raoul [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Heck, Olivier [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Moreno, Ricardo [Auteur]
Service Neurologie [CHU Clermont-Ferrand]
L'allinec, Vicent [Auteur]
Département de Neuro-Radiologie [Angers] [DNR - Angers]
Lapergue, Bertrand [Auteur]
Hôpital Foch [Suresnes]
Marnat, Gaultier [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]

Journal title :

Journal of Neurointerventional Surgery

Abbreviated title :

J Neurointerv Surg

Publication date :

2022-12-03

ISSN :

1759-8486

English keyword(s) :

Stroke
Thrombectomy
Thrombolysis

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background Intravenous thrombolysis (IVT) for patients treated with mechanical thrombectomy (MT) for proximal occlusions has recently been questioned through randomized trials. However, few patients with M2 occlusions were ...
Show more >Background Intravenous thrombolysis (IVT) for patients treated with mechanical thrombectomy (MT) for proximal occlusions has recently been questioned through randomized trials. However, few patients with M2 occlusions were included. We investigated the influence of prior IVT for patients presenting M2 occlusions treated with MT in comparison with MT alone. Methods We conducted a retrospective analysis of the Endovascular Treatment in Ischemic Stroke (ETIS) registry, a multicenter observational study. Data from consecutive patients treated with MT for M2 occlusions between January 2015 and January 2022 at 26 comprehensive stroke centers were analyzed. The primary endpoint was 90-day modified Rankin Scale score of 0–2. Outcomes were compared using propensity score approaches. We also performed sensitivity analysis in relevant subgroups of patients. Results Among 1132 patients with M2 occlusions treated with MT, 570 received prior IVT. The two groups were comparable after propensity analysis. The rate of favorable functional outcome was significantly higher in the IVT+MT group compared with the MT alone group (59.8% vs 44.7%; adjusted OR 1.38, 95% CI 1.10 to 1.75, P=0.008). Hemorrhagic and procedural complications were similar in both groups. In sensitivity analysis excluding patients with anticoagulation treatment, favorable recanalization was more frequent in the IVT+MT group (OR 1.37, 95% CI 1.11 to 1.70, P=0.004). Conclusions In cases of M2 occlusions, prior IVT combined with MT resulted in better functional outcome than MT alone, without increasing the rate of hemorrhagic or procedural complications. These results suggest the benefit of IVT in patients undergoing MT for M2 occlusions.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

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

Submission date :

2023-11-15T02:55:56Z
2024-01-18T13:11:55Z