Titre :

Impact of Antiplatelet Therapy During Endovascular Therapy for Tandem Occlusions: A Collaborative Pooled Analysis.

Auteur(s) :

Zhu, François [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Anadani, Mohammad [Auteur]
Washington State University [WSU]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Spiotta, Alejandro [Auteur]
Medical University of South Carolina [Charleston] [MUSC]
Turjman, Francis [Auteur]
Service de neuroradiologie [Lyon]
Piotin, Michel [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Steglich-Arnholm, Henrik [Auteur]
Rigshospitalet [Copenhagen]
Holtmannspötter, Markus [Auteur]
Rigshospitalet [Copenhagen]
Taschner, Christian [Auteur]
Universitäts Klinikum Freiburg = University Medical Center Freiburg [Uniklinik]
Eiden, Sebastian [Auteur]
Universitäts Klinikum Freiburg = University Medical Center Freiburg [Uniklinik]
Haussen, Diogo C. [Auteur]
Emory University [Atlanta, GA]
Nogueira, Raul G. [Auteur]
Emory University [Atlanta, GA]
Papanagiotou, Panagiotis [Auteur]
Boutchakova, Maria [Auteur]
Siddiqui, Adnan H. [Auteur]

Lapergue, Bertrand [Auteur]
Hôpital Foch [Suresnes]
Dorn, Franziska [Auteur]
University-Hospital Munich-Großhadern [München]
Cognard, Christophe [Auteur]
Service Neuroradiologie Diagnostique et Thérapeutique [CHU Toulouse]
Killer-Oberpfalzer, Monika [Auteur]
Paracelsus Medizinische Privatuniversität = Paracelsus Medical University [PMU]
Mangiafico, Salvatore [Auteur]
Azienda Ospedaliero Universitaria Careggi [Firenze] = Careggi University Hospital [Florence, Italy] [AOUC]
Ribo, Marc [Auteur]
Vall d'Hebron University Hospital [Barcelona]
Psychogios, Marios N. [Auteur]
University Medical Center Göttingen [UMG]
Labeyrie, Marc-Antoine [Auteur]
Service de Neuroradiologie [CHU Lariboisière]
Mazighi, Mikael [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Biondi, Alessandra [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Anxionnat, René [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Bracard, Serge [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Richard, Sébastien [Auteur]
Service de neurologie [CHRU Nancy]
Gory, Benjamin [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Richard, Sébastien [Auteur]

Titre de la revue :

Stroke

Nom court de la revue :

Stroke

Numéro :

51

Pagination :

1522–1529

Date de publication :

2020-03-21

ISSN :

1524-4628

Mot(s)-clé(s) en anglais :

antiplatelet
cerebral hemorrhage
infarction
prognosis

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Background and Purpose— Antiplatelet agents could be used in the setting of endovascular therapy for tandem occlusions to reduce the risk of de novo intracranial embolic migration, reocclusion of the extracranial internal ...
Lire la suite >Background and Purpose— Antiplatelet agents could be used in the setting of endovascular therapy for tandem occlusions to reduce the risk of de novo intracranial embolic migration, reocclusion of the extracranial internal carotid artery lesion, or in-stent thrombosis in case of carotid stent placement but have to be balanced with the intracerebral hemorrhagic transformation risk. In this study, we aim to investigate the impact of acute antiplatelet therapy administration on outcomes during endovascular therapy for anterior circulation tandem occlusions. Methods— This is a retrospective analysis of a collaborative pooled analysis of 11 prospective databases from the multicenter observational TITAN registry (Thrombectomy in Tandem Lesions). Patients were divided into groups based on the number of antiplatelet administered during endovascular therapy. The primary outcome was favorable outcome, defined as a modified Rankin Scale score of 0 to 2 at 90 days. Results— This study included a total of 369 patients; 145 (39.3%) did not receive any antiplatelet agent and 224 (60.7%) received at least 1 antiplatelet agent during the procedure. Rate of favorable outcome was nonsignificantly higher in patients treated with antiplatelet therapy (58.3%) compared with those treated without antiplatelet (46.0%; adjusted odds ratio, 1.38 [95% CI, 0.78–2.43]; P=0.26). Rate of 90-day mortality was significantly lower in patients treated with antiplatelet therapy (11.2% versus 18.7%; adjusted odds ratio, 0.47 [95% CI, 0.22–0.98]; P=0.042), without increasing the risk of any intracerebral hemorrhage. Successful reperfusion (modified Thrombolysis in Cerebral Ischemia score 2b-3) rate was significantly better in the antiplatelet therapy group (83.9% versus 71.0%; adjusted odds ratio, 1.89 [95% CI, 1.01–3.64]; P=0.045). Conclusions— Administration of antiplatelet therapy during endovascular therapy for anterior circulation tandem occlusions was safe and was associated with a lower 90-day mortality. Optimal antiplatelet therapy remains to be assessed, especially when emergent carotid artery stenting is performed. Further randomized controlled trials are needed.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 :

2023-11-15T09:09:39Z
2023-12-14T12:24:18Z