Thrombectomy for Basilar Artery Occlusion ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Thrombectomy for Basilar Artery Occlusion with Mild Symptoms.
Auteur(s) :
Guenego, A. [Auteur]
Dargazanli, C. [Auteur]
Weisenburger-Lile, D. [Auteur]
Gory, B. [Auteur]
Richard, S. [Auteur]
Ducroux, C. [Auteur]
Piotin, M. [Auteur]
Blanc, R. [Auteur]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Lucas, L. [Auteur]
Aubertin, M. [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]
Consoli, A. [Auteur]
Lapergue, B. [Auteur]
Fahed, R. [Auteur]
Dargazanli, C. [Auteur]
Weisenburger-Lile, D. [Auteur]
Gory, B. [Auteur]
Richard, S. [Auteur]
Ducroux, C. [Auteur]
Piotin, M. [Auteur]
Blanc, R. [Auteur]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Lucas, L. [Auteur]
Aubertin, M. [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]
Consoli, A. [Auteur]
Lapergue, B. [Auteur]
Fahed, R. [Auteur]
Titre de la revue :
World Neurosurg
Nom court de la revue :
World Neurosurg
Numéro :
149
Pagination :
e400-e414
Date de publication :
2021-05
ISSN :
1878-8769
Mot(s)-clé(s) :
Endovascular recanalization
Mild symptoms
Thrombectomy
Stroke
Mild symptoms
Thrombectomy
Stroke
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Background and Objective
To evaluate outcomes of thrombectomy in patients with a basilar artery occlusion (BAO) and mild symptoms, defined by an initial National Institutes of Health Stroke Scale (NIHSS) score ...
Lire la suite >Background and Objective To evaluate outcomes of thrombectomy in patients with a basilar artery occlusion (BAO) and mild symptoms, defined by an initial National Institutes of Health Stroke Scale (NIHSS) score ≤6. Methods We performed a retrospective analysis of a multicenter prospective cohort of consecutive patients with acute ischemic stroke with BAO who underwent thrombectomy. We compared baseline and procedural characteristics, as well as outcomes between patients with BAO with an NIHSS score ≤6 and >6. Multivariate analyses were performed to determine baseline and procedural predictors of good outcome (modified Rankin Scale score 0–2) among patients with an NIHSS score ≤6. Results A total of 269 patients were included: 50 (19%) had an initial NIHSS score ≤6 and 219 (81%) had an NIHSS score >6. Patients with mild strokes (NIHSS score ≤6) had better outcomes (68% of modified Rankin Scale score 0–2 vs. 27% for NIHSS score >6; P < 0.0001), lower mortality (14% vs. 48; P < 0.0001) and fewer parenchymal hematomas at day 1 (0% vs. 10%; P = 0.016). A multivariate analysis identified the following predictors for good outcome among patients with BAO with an NIHSS score ≤6: younger age, fewer passes, a cardioembolic cause, and the absence of need for angioplasty/stenting. Conclusions Thrombectomy seems to be safer and more effective for mild BAO strokes with NIHSS score ≤6 than for more severe patients. Even although thrombectomy showed high rates of recanalization, a substantial proportion (32%) nevertheless had a poor long-term clinical outcome. The number of passes, patient's age, and stroke cause seem to be predictors of clinical outcome.Lire moins >
Lire la suite >Background and Objective To evaluate outcomes of thrombectomy in patients with a basilar artery occlusion (BAO) and mild symptoms, defined by an initial National Institutes of Health Stroke Scale (NIHSS) score ≤6. Methods We performed a retrospective analysis of a multicenter prospective cohort of consecutive patients with acute ischemic stroke with BAO who underwent thrombectomy. We compared baseline and procedural characteristics, as well as outcomes between patients with BAO with an NIHSS score ≤6 and >6. Multivariate analyses were performed to determine baseline and procedural predictors of good outcome (modified Rankin Scale score 0–2) among patients with an NIHSS score ≤6. Results A total of 269 patients were included: 50 (19%) had an initial NIHSS score ≤6 and 219 (81%) had an NIHSS score >6. Patients with mild strokes (NIHSS score ≤6) had better outcomes (68% of modified Rankin Scale score 0–2 vs. 27% for NIHSS score >6; P < 0.0001), lower mortality (14% vs. 48; P < 0.0001) and fewer parenchymal hematomas at day 1 (0% vs. 10%; P = 0.016). A multivariate analysis identified the following predictors for good outcome among patients with BAO with an NIHSS score ≤6: younger age, fewer passes, a cardioembolic cause, and the absence of need for angioplasty/stenting. Conclusions Thrombectomy seems to be safer and more effective for mild BAO strokes with NIHSS score ≤6 than for more severe patients. Even although thrombectomy showed high rates of recanalization, a substantial proportion (32%) nevertheless had a poor long-term clinical outcome. The number of passes, patient's age, and stroke cause seem to be predictors of clinical outcome.Lire moins >
Langue :
Anglais
Comité de lecture :
Oui
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
Université de Lille
CHU Lille
CHU Lille
Date de dépôt :
2023-11-15T07:14:35Z
2023-11-30T08:49:49Z
2023-11-30T08:49:49Z