Title :

Impact of Strategy on Clinical Outcome in Large Vessel Occlusion Stroke Successfully Reperfused: ETIS Registry Results

Author(s) :

Douarinou, M. [Auteur]
Gory, B. [Auteur]
Consoli, A. [Auteur]
Lapergue, B. [Auteur]
Kyheng, Maéva [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Anadani, M. [Auteur]
Blanc, R. [Auteur]
Marnat, G. [Auteur]
Bourcier, R. [Auteur]
Sibon, I. [Auteur]
Eugène, F. [Auteur]
Vannier, S. [Auteur]
Audibert, G. [Auteur]
Mione, G. [Auteur]
Richard, S. [Auteur]

Journal title :

Stroke

Abbreviated title :

Stroke

Volume number :

53

Pages :

p. e1 - e4

Publication date :

2022-01

ISSN :

1524-4628

English keyword(s) :

cerebral infarction
ischemic stroke
propensity score
reperfusion
thrombectomy

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background and Purpose: Approximately half of the patients with acute ischemic stroke due to anterior circulation large vessel occlusion do not achieve functional independence despite successful reperfusion. We aimed ...
Show more >Background and Purpose: Approximately half of the patients with acute ischemic stroke due to anterior circulation large vessel occlusion do not achieve functional independence despite successful reperfusion. We aimed to determine influence of reperfusion strategy (bridging therapy, intravenous thrombolysis alone, or mechanical thrombectomy alone) on clinical outcomes in this population. Methods: From ongoing, prospective, multicenter, observational Endovascular Treatment in Ischemic Stroke registry in France, all patients with anterior circulation large vessel occlusion who achieved successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b-3) following reperfusion therapy were included. Primary end point was favorable outcome, defined as 90-day modified Rankin Scale score ≤2. Patient groups were compared using those treated with bridging therapy as reference. Differences in baseline characteristics were reduced after propensity score-matching, with a maximum absolute standardized difference of 14% for occlusion site. Results: Among 1872 patients included, 970 (51.8%) received bridging therapy, 128 (6.8%) received intravenous thrombolysis alone, and the remaining 774 (41.4%) received MT alone. The rate of favorable outcome was comparable between groups. Excellent outcome (90-day modified Rankin Scale score 0–1) was achieved more frequently in the bridging therapy group compared with the MT alone (odds ratio after propensity score-matching, 0.70 [95% CI, 0.50–0.96]). Regarding safety outcomes, hemorrhagic complications were similar between the groups, but 90-day mortality was significantly higher in the MT alone group compared with the bridging therapy group (odds ratio, 1.60 [95% CI, 1.09–2.37]). Conclusions: This real-world observational study of patients with anterior circulation large vessel occlusion demonstrated a similar rate of favorable outcome following successful reperfusion with different therapeutic strategies. However, our results suggest that bridging therapy compared with MT alone is significantly associated with excellent clinical outcome and lower mortality.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 :

2023-11-15T05:39:12Z
2024-03-13T10:48:09Z