Title :

Early successful reperfusion after EVT reduces malignant MCA infarction occurrence in young patients with large DWI lesions.

Author(s) :

Sabben, Candice [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Desilles, Jean-Philippe [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Charbonneau, Frederique [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Savatovsky, Julien [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Morvan, Erwan [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Obadia, Alexandre [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Raynouard, Igor [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Fela, Fouzia [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Escalard, Simon [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Redjem, Hocine [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Smajda, Stanislas [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Ciccio, Gabriele [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Blanc, Raphaël [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Fahed, Robert [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Le Guerinel, Caroline [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Engrand, Nicolas [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Ben Maacha, Malek [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Mazighi, Mikael [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Piotin, Michel [Auteur]
Service de neuroradiologie [Paris]
Obadia, Michael [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]

Journal title :

European Journal of Paediatric Neurology

Abbreviated title :

Eur. J. Neurol.

Volume number :

27

Pages :

1988-1995

Publication date :

2020-05-23

ISSN :

1468-1331

English keyword(s) :

malignant
craniectomy
stroke
thrombectomy

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background and purpose Malignant middle cerebral artery infarction (MMI) is a severe complication of acute ischaemic stroke (AIS). The aim of our study was to assess whether successful reperfusion after endovascular therapy ...
Show more >Background and purpose Malignant middle cerebral artery infarction (MMI) is a severe complication of acute ischaemic stroke (AIS). The aim of our study was to assess whether successful reperfusion after endovascular therapy (EVT) in AIS with clinical and imaging predictors of MMI decreased its occurrence. Methods Data were collected between January 2014 and July 2018 in a monocentric prospective AIS registry of patients treated with EVT. Patients selected were <65 years old with severe anterior circulation AIS with a National Institutes of Health Stroke Scale score >15, baseline Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Score ≤ 6 and baseline diffusion-weighted imaging lesion volume >82 mL within 6 h of symptom onset. Successful reperfusion was defined as a Thrombolysis in Cerebral Ischemia score ≥ 2b. Occurrence of MMI was the primary endpoint. Results A total of 66 EVT-treated patients were included in our study. MMI occurred in 27 patients (41%). In unadjusted analysis, successful reperfusion was associated with fewer MMIs (31.8% vs. 65.0%; P = 0.015) and with more favorable outcome at 3 months (50% vs. 20%; P = 0.023). In multivariate analysis, successful reperfusion was associated with an adjusted odds ratio (95% confidence intervals) of 0.35 (0.10–1.12) for MMI and 2.77 (0.84–10.43) for 3-month favorable outcome occurrence. Conclusions Early successful reperfusion performed in patients with AIS with clinical and imaging predictors of MMI was associated with decreased MMI occurrence. Reperfusion status might be considered in evaluating the need for craniectomy in patients with early predictors of MMI.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 :

2023-11-15T08:50:59Z
2023-12-19T13:25:33Z