Title :

Endovascular treatment of ischemic stroke due to isolated internal carotid artery occlusion: ETIS registry data analysis.

Author(s) :

Ter Schiphorst, Adrien [Auteur]
Hôpital Gui de Chauliac [CHU Montpellier]
Peres, Roxane [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Dargazanli, Cyril [Auteur]
Hôpital Gui de Chauliac [CHU Montpellier]
Blanc, Raphael [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Gory, Benjamin [Auteur]
Imagerie Adaptative Diagnostique et Interventionnelle [IADI]
Richard, Sebastien [Auteur]
Défaillance Cardiovasculaire Aiguë et Chronique [DCAC]
Marnat, Gaultier [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU de Bordeaux]
Sibon, Igor [Auteur]
Hôpital Haut-Lévêque [CHU Bordeaux]
Guillon, Benoit [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Bourcier, Romain [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Denier, Christian [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Spelle, Laurent [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Consoli, Arturo [Auteur]
Hôpital Foch [Suresnes]
Lapergue, Bertrand [Auteur]
Hôpital Foch [Suresnes]
Costalat, Vincent [Auteur]
Hôpital Gui de Chauliac [CHU Montpellier]
Obadia, Michael [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Arquizan, Caroline [Auteur]
Hôpital Gui de Chauliac [CHU Montpellier]

Journal title :

Journal of Neurology

Abbreviated title :

J Neurol

Volume number :

269

Pages :

4383–4395

Publication date :

2022-04-02

ISSN :

1432-1459

English keyword(s) :

Thrombectomy
Stroke
Thrombolysis
Cervical
Stent

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background The best treatment for acute ischemic stroke (AIS) due to isolated cervical internal carotid artery occlusion (CICAO) (i.e., without associated occlusion of the circle of Willis) is still unknown. In this ...
Show more >Background The best treatment for acute ischemic stroke (AIS) due to isolated cervical internal carotid artery occlusion (CICAO) (i.e., without associated occlusion of the circle of Willis) is still unknown. In this study, we aimed to describe EVT safety and clinical outcome in patients with CICAO. Methods We analyzed data of all consecutive patients, included in the Endovascular Treatment in Ischemic Stroke (ETIS) Registry between 2013 and 2020, who presented AIS and proven CICAO on angiogram and underwent EVT. We assessed carotid recanalization, procedural complications, National Institutes of Health Stroke Scale (NIHSS) at 24 h post-EVT, and 3-month favorable outcome (modified Rankin Scale, mRS ≤ 2 or equal to the pre-stroke value). Results Forty-five patients were included (median age: 70 years; range: 62–82 years). The median NIHSS before EVT was 14 (9–21). Carotid stenting was performed in 23 (51%) patients. Carotid recanalization at procedure end and on control imaging was observed in 37 (82%) and 29 (70%) patients, respectively. At day 1 post-EVT, the NIHSS remained stable or decreased in 25 (60%) patients; 12 (29%) patients had early neurologic deterioration (NIHSS ≥ 4 points). The rate of procedural complications was 36%, including stent thrombosis (n = 7), intracranial embolism (n = 7), and symptomatic intracranial hemorrhage (n = 1). At 3 months, 18 (40%) patients had a favorable outcome, and 10 (22%) were dead. Conclusion Our study suggests that EVT in AIS patients with moderate/severe initial deficit due to CICAO led to high rate of recanalization at day 1, and a 40% rate of favorable outcome at 3 months. There was a high rate of procedural complication which is of concern. Randomized controlled trials assessing the superiority of EVT in patients with CICAO and severe deficits are needed.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 :

2023-11-15T04:23:21Z
2024-05-17T06:15:02Z