Title :

Thrombolysis Improves Reperfusion and the Clinical Outcome in Tandem Occlusion Stroke Related to Cervical Dissection: TITAN and ETIS Pooled Analysis

Author(s) :

Marnat, G. [Auteur]
Université de Bordeaux [UB]
Sibon, I. [Auteur]
Université de Bordeaux [UB]
Bourcier, R. [Auteur]
Nantes Université [Nantes Univ]
Anadani, M. [Auteur]
Gariel, F. [Auteur]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Kyheng, Maéva [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Mazighi, M. [Auteur]
Dargazanli, C. [Auteur]
Piotin, M. [Auteur]
Consoli, A. [Auteur]
Blanc, R. [Auteur]
Anxionnat, R. [Auteur]
Université de Lorraine [UL]
Audibert, G. [Auteur]
Université de Lorraine [UL]
Richard, S. [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Lapergue, B. [Auteur]
Hôpital Foch [Suresnes]
Gory, B. [Auteur]
Université de Lorraine [UL]

Journal title :

Journal of Stroke

Abbreviated title :

J. Stroke

Volume number :

23

Pages :

p. 411-419

Publication date :

2021

ISSN :

2287-6391

English keyword(s) :

Stroke
Internal carotid artery
Dissection
Reperfusion
Thrombolytic therapy

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

J Stroke > Volume 23(3); 2021 > Article Original Article Journal of Stroke 2021;23(3):411-419. Published online: September 30, 2021 DOI: https://doi.org/10.5853/jos.2020.04889 Thrombolysis Improves Reperfusion ...
Show more >J Stroke > Volume 23(3); 2021 > Article Original Article Journal of Stroke 2021;23(3):411-419. Published online: September 30, 2021 DOI: https://doi.org/10.5853/jos.2020.04889 Thrombolysis Improves Reperfusion and the Clinical Outcome in Tandem Occlusion Stroke Related to Cervical Dissection: TITAN and ETIS Pooled Analysis Gaultier Marnata, Igor Sibonb, Romain Bourcierc, Mohammad Anadanid, Florent Gariela, Julien Labreuchee, Maeva Kyhenge, Mikael Mazighif, Cyril Dargazanlig, Michel Piotinf, Arturo Consolih, Raphaël Blancf, René Anxionnati,j, Gérard Audibertk, Sébastien Richardl, Bertrand Laperguem, Benjamin Goryi,j; on Behalf of ETIS and TITAN Investigators aDepartment of Neuroradiology, University Hospital of Bordeaux, Bordeaux, France bDepartment of Neurology, University Hospital of Bordeaux, Bordeaux, France cDepartment of Neuroradiology, University Hospital of Nantes, Nantes, France dDepartment of Neurology, Washington University School of Medicine, St. Louis, MO, USA eDepartment of Biostatistics, University of Lille, Lille, France fDepartment of Interventional Neuroradiology, Rothschild Foundation, Paris, France gDepartment of Neuroradiology, CHRU Gui-de-Chauliac, Montpellier, France hDepartment of Neuroradiology, Foch Hospital, Versailles Saint-Quentin-en-Yvelines University, Suresnes, France iDepartment of Diagnostic and Therapeutic Neuroradiology, University of Lorraine, CHRU-Nancy, Nancy, France jUniversité de Lorraine, IADI, INSERM U1254, Nancy, France kDepartment of Anesthesiology and Intensive Care, University of Lorraine, University Hospital of Nancy, Nancy, France lStroke Unit, Department of Neurology, University of Lorraine, University Hospital of Nancy, and INSERM U1116, Nancy, France mDepartment of Neurology, Foch Hospital, Versailles Saint-Quentin-en-Yvelines University, Suresnes, France Correspondence: Gaultier Marnat Department of Neuroradiology, University Hospital of Bordeaux, Hôpital Pellegrin, Place Amélie Raba-Léon, Bordeaux 33000, France Tel: +33-557821765 Fax: +33-556795939 E-mail: gaultier.marnat@chu-bordeaux.fr Received December 9, 2020 Revised May 6, 2021 Accepted September 8, 2021 Copyright © 2021 Korean Stroke Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background and Purpose Despite the widespread adoption of mechanical thrombectomy (MT) for the treatment of large vessel occlusion stroke (LVOS) in the anterior circulation, the optimal strategy for the treatment tandem occlusion related to cervical internal carotid artery (ICA) dissection is still debated. This individual patient pooled analysis investigated the safety and efficacy of prior intravenous thrombolysis (IVT) in anterior circulation tandem occlusion related to cervical ICA dissection treated with MT. Methods We performed a retrospective analysis of two merged prospective multicenter international real-world observational registries: Endovascular Treatment in Ischemic Stroke (ETIS) and Thrombectomy In TANdem occlusions (TITAN) registries. Data from MT performed in the treatment of tandem LVOS related to cervical ICA dissection between January 2012 and December 2019 at 24 comprehensive stroke centers were analyzed. The primary endpoint was a favorable outcome defined as 90-day modified Rankin Scale (mRS) score of 0-2. Results The study included 144 patients with tandem occlusion LVOS due to cervical ICA dissection, of whom 94 (65.3%) received IVT before MT. Prior IVT was significantly associated with a better clinical outcome considering the mRS shift analysis (common odds ratio, 2.59; 95% confidence interval [CI], 1.35 to 4.93; P=0.004 for a 1-point improvement) and excellent outcome (90-day mRS 0-1) (adjusted odds ratio [aOR], 4.23; 95% CI, 1.60 to 11.18). IVT was also associated with a higher rate of intracranial successful reperfusion (83.0% vs. 64.0%; aOR, 2.70; 95% CI, 1.21 to 6.03) and a lower rate of symptomatic intracranial hemorrhage (4.3% vs. 14.8%; aOR, 0.21; 95% CI, 0.05 to 0.80). Conclusions Prior IVT before MT for the treatment of tandem occlusion related to cervical ICA dissection was safe and associated with an improved 90-day functional outcome.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 :

2023-11-15T05:45:37Z
2024-02-14T11:10:06Z