Titre :

Thrombectomy for Comatose Patients with Basilar Artery Occlusion : A Multicenter Study.

Auteur(s) :

Guenego, A. [Auteur]
Lucas, L. [Auteur]
Gory, B. [Auteur]
Richard, S. [Auteur]
Aubertin, M. [Auteur]
Weisenburger-Lile, D. [Auteur]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Dargazanli, C. [Auteur]
Benali, A. [Auteur]
Bourcier, R. [Auteur]
Detraz, L. [Auteur]
Vannier, S. [Auteur]
Guillen, M. [Auteur]
Eugene, F. [Auteur]
Walker, G. [Auteur]
Lun, R. [Auteur]
Wormsbecker, A. [Auteur]
Ducroux, C. [Auteur]
Piotin, M. [Auteur]
Blanc, R. [Auteur]
Consoli, A. [Auteur]
Lapergue, B. [Auteur]
Fahed, R. [Auteur]

Titre de la revue :

Clinical Neuroradiology

Nom court de la revue :

Clin Neuroradiol

Numéro :

31

Pagination :

p. 1131–1140

Date de publication :

2021

ISSN :

1869-1447

Mot(s)-clé(s) en anglais :

Stroke
Endovascular revascularization
Thrombectomy
Posterior circulation
Coma

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Purpose Acute ischemic stroke (AIS) secondary to a basilar artery occlusion (BAO) carries a poor prognosis, especially in cases of severe symptoms, such as coma at presentation. Despite a lack of evidence, mechanical ...
Lire la suite >Purpose Acute ischemic stroke (AIS) secondary to a basilar artery occlusion (BAO) carries a poor prognosis, especially in cases of severe symptoms, such as coma at presentation. Despite a lack of evidence, mechanical thrombectomy (MT) is often performed as the procedural risks are felt to be minimal compared to the natural history. We sought to evaluate MT efficacy and safety in comatose BAO patients. Methods We performed a retrospective analysis of a multicenter prospective cohort of consecutive AIS patients with BAO who underwent MT. We compared baseline characteristics between comatose and noncomatose BAO patients, as well as clinical outcomes (modified Rankin scale, mRS 0–3 at 3 months). Using a multivariate logistic regression, we examined the population of comatose patients for baseline predictive factors of mortality. Results We included 269 patients, 72 (27%) comatose and 197 (73%) non-comatose. Despite similar recanalization rates between comatose and non-comatose patients (83% vs. 90% p = 0.221), comatose patient long-term outcomes were dramatically worse (11% mRS 0–3 vs. 54%, p < 0.0001) and mortality was higher (64% vs. 34%, p < 0.0001). Baseline predictors of mortality at 3 months among comatose BAO patients after multivariate analysis were the following: male sex (odds ratio, OR 31.20, 2.57–378.52, p = 0.007), older age (OR 1.13, 1.04–1.24, p = 0.007) and higher serum glucose levels (OR 1.54, 1.07–2.21, p = 0.019). Conclusion Thrombectomy is technically effective for BAO patients presenting with coma; however, the long-term favorable outcome remains poor. Male sex, old age and hyperglycemia were predictors of mortality in these patients.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

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

Date de dépôt :

2023-11-15T07:07:05Z
2024-04-08T14:43:20Z