Endovascular Thrombectomy for Distal Medium ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Endovascular Thrombectomy for Distal Medium Vessel Occlusions of the Middle Cerebral Artery: a Safe and Effective Procedure.
Author(s) :
Marchal, Adrien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bretzner, Martin [Auteur]
Department of Psychiatry Massachusetts General Hospital [MGH]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Casolla, Barbara [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Kyheng, MaÉva [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Service de Biostatistiques [CHRU Lille]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Service de Biostatistiques [CHRU Lille]
Personnic, Thomas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Cordonnier, Charlotte [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Lille Neurosciences & Cognition (LilNCog) - U 1172
Henon, Hilde [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Lille Neurosciences & Cognition (LilNCog) - U 1172
Bricout, Nicolas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bretzner, Martin [Auteur]
Department of Psychiatry Massachusetts General Hospital [MGH]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Casolla, Barbara [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Kyheng, MaÉva [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Service de Biostatistiques [CHRU Lille]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Service de Biostatistiques [CHRU Lille]
Personnic, Thomas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Cordonnier, Charlotte [Auteur]

Troubles cognitifs dégénératifs et vasculaires - U1171
Lille Neurosciences & Cognition (LilNCog) - U 1172
Henon, Hilde [Auteur]

Troubles cognitifs dégénératifs et vasculaires - U1171
Lille Neurosciences & Cognition (LilNCog) - U 1172
Bricout, Nicolas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Journal title :
World Neurosurgery
Abbreviated title :
World Neurosurg
Publication date :
2022-01-09
ISSN :
1878-8769
English keyword(s) :
Acute ischemic stroke
Distal occlusions
Endovascular thrombectomy
Reperfusion
Distal occlusions
Endovascular thrombectomy
Reperfusion
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background
Distal medium vessel occlusions (DMVOs) are increasingly recognized as a next target for endovascular thrombectomy (EVT). Our objective was to investigate safety and clinical outcomes of EVT for DMVO of the ...
Show more >Background Distal medium vessel occlusions (DMVOs) are increasingly recognized as a next target for endovascular thrombectomy (EVT). Our objective was to investigate safety and clinical outcomes of EVT for DMVO of the middle cerebral artery (MCA). Methods We analyzed data of the Lille Reperfusion Registry from January 2017 to September 2020. Patients with a primary or secondary DMVO of the MCA seen on pretreatment angiogram were included. Only patients with a eTICI score 2b50–2b67 on initial angiogram were considered. Baseline characteristics, angiographic clinical, and safety outcomes were compared between patients treated with EVT or standard medical treatment (no-EVT). Results Of the 171 patients included, 96 received EVT (46.9% male, 68.7 ± 15.8 years) and 75 received standard medical treatment (44% male, 73.9 ± 13.1 years). EVT patients had a better improvement of the NIHSS score at discharge (adjusted mean difference: 3.71; 95% CI: 1.18–6.24). In the distal M2 occlusions subgroup, EVT was significantly associated with a higher rate of early neurologic improvement (adjusted OR: 3.62 95% CI: 1.31–10.03), NIHSS improvement at discharge (adjusted mean difference: 5.23; 95% CI: 2.18–8.29), and improved modified Rankin Scale score at 3 months (adjusted common OR for 1 point improvement: 3.06; 95% CI: 1.30 to 7.23). Symptomatic intracranial hemorrhage occurred in 3.1% in the EVT group and in 9.5% in the no-EVT group. Conclusions EVT for DMVO of the MCA appears to be safe and may lead to improved clinical outcomes. This effect was especially pronounced in patients with distal M2 occlusions, warranting randomized trials to validate this result.Show less >
Show more >Background Distal medium vessel occlusions (DMVOs) are increasingly recognized as a next target for endovascular thrombectomy (EVT). Our objective was to investigate safety and clinical outcomes of EVT for DMVO of the middle cerebral artery (MCA). Methods We analyzed data of the Lille Reperfusion Registry from January 2017 to September 2020. Patients with a primary or secondary DMVO of the MCA seen on pretreatment angiogram were included. Only patients with a eTICI score 2b50–2b67 on initial angiogram were considered. Baseline characteristics, angiographic clinical, and safety outcomes were compared between patients treated with EVT or standard medical treatment (no-EVT). Results Of the 171 patients included, 96 received EVT (46.9% male, 68.7 ± 15.8 years) and 75 received standard medical treatment (44% male, 73.9 ± 13.1 years). EVT patients had a better improvement of the NIHSS score at discharge (adjusted mean difference: 3.71; 95% CI: 1.18–6.24). In the distal M2 occlusions subgroup, EVT was significantly associated with a higher rate of early neurologic improvement (adjusted OR: 3.62 95% CI: 1.31–10.03), NIHSS improvement at discharge (adjusted mean difference: 5.23; 95% CI: 2.18–8.29), and improved modified Rankin Scale score at 3 months (adjusted common OR for 1 point improvement: 3.06; 95% CI: 1.30 to 7.23). Symptomatic intracranial hemorrhage occurred in 3.1% in the EVT group and in 9.5% in the no-EVT group. Conclusions EVT for DMVO of the MCA appears to be safe and may lead to improved clinical outcomes. This effect was especially pronounced in patients with distal M2 occlusions, warranting randomized trials to validate this result.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Submission date :
2023-11-15T05:11:25Z
2024-01-12T14:37:19Z
2024-01-12T14:37:19Z