Effect of the phenotype of the m1-middle ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Effect of the phenotype of the m1-middle cerebral artery occlusion on the recanalization rates in the aster trial
Auteur(s) :
Consoli, Arturo [Auteur]
Service Neuroradiologie diagnostique et interventionnelle [Hôpital Foch]
Zhu, François [Auteur]
Bourcier, Romain [Auteur]
Dargazanli, Cyril [Auteur]
Marnat, Gaultier [Auteur]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Blanc, Raphael [Auteur]
Saleme, Suzana [Auteur]
Costalat, Vincent [Auteur]
Desal, Hubert [Auteur]
Bracard, Serge [Auteur]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Kyheng, Maéva [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Puccinelli, Francesco [Auteur]
Mosimann, Pascal J. [Auteur]
Gory, Benjamin [Auteur]
Piotin, Michel [Auteur]
Lapergue, Bertrand [Auteur]
Hôpital Foch [Suresnes]
Service Neuroradiologie diagnostique et interventionnelle [Hôpital Foch]
Zhu, François [Auteur]
Bourcier, Romain [Auteur]
Dargazanli, Cyril [Auteur]
Marnat, Gaultier [Auteur]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Blanc, Raphael [Auteur]
Saleme, Suzana [Auteur]
Costalat, Vincent [Auteur]
Desal, Hubert [Auteur]
Bracard, Serge [Auteur]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Kyheng, Maéva [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Puccinelli, Francesco [Auteur]
Mosimann, Pascal J. [Auteur]
Gory, Benjamin [Auteur]
Piotin, Michel [Auteur]
Lapergue, Bertrand [Auteur]
Hôpital Foch [Suresnes]
Titre de la revue :
Journal of Neurointerventional Surgery
Nom court de la revue :
J Neurointerv Surg
Numéro :
12
Éditeur :
BMJ Publishing Group
Date de publication :
2019-06-28
ISSN :
1759-8486
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
BACKGROUND: An adequate recanalization grade is an independent predictor of a good clinical outcome in patients with acute ischemic stroke. It can be obtained with stent retrievers (SR) and contact aspiration (CA). The aim ...
Lire la suite >BACKGROUND: An adequate recanalization grade is an independent predictor of a good clinical outcome in patients with acute ischemic stroke. It can be obtained with stent retrievers (SR) and contact aspiration (CA). The aim of this ancillary study of the ASTER trial was to investigate the effect of the regular and irregular phenotype of the M1-middle cerebral artery (M1-MCA) segment occlusion on the procedural and clinical outcomes in the ASTER trial population. METHODS: The predetermined occlusion phenotype assessment was performed by the core laboratory of the ASTER trial and patients with M1-MCA occlusion were included in this study. Clinical and procedural outcomes were analyzed according to the technique used and to the occlusion phenotype. RESULTS: 188 patients were included in the analysis (95 received SR, 93 CA as first-line treatment). The occlusion phenotypes were graded as irregular in 52.7% of cases (n=99, 95% CI 45.5% to 59.8%). In patients with an irregular occlusion phenotype, complete or adequate recanalization at the end of the first-line strategy was more often achieved with SR than CA (TICI 3: SR 44.1% vs CA 22.5%, OR 0.35, 95% CI 0.14 to 0.89, p=0.027), with a shorter procedure time, a lower number of passes (>2 passes: SR 32.2% vs CA 57.5%, OR 3.31, 95% CI 1.36 to 8.03, p=0.009), and higher rates of favorable clinical outcome (SR 55.2% vs CA 31.6%, OR 0.40, 95% CI 0.16 to 0.97, p=0.042). CONCLUSIONS: Irregular M1-MCA occlusion phenotypes treated with SR as first-line approach were associated with better procedural and clinical outcomes in the ASTER trial population.Lire moins >
Lire la suite >BACKGROUND: An adequate recanalization grade is an independent predictor of a good clinical outcome in patients with acute ischemic stroke. It can be obtained with stent retrievers (SR) and contact aspiration (CA). The aim of this ancillary study of the ASTER trial was to investigate the effect of the regular and irregular phenotype of the M1-middle cerebral artery (M1-MCA) segment occlusion on the procedural and clinical outcomes in the ASTER trial population. METHODS: The predetermined occlusion phenotype assessment was performed by the core laboratory of the ASTER trial and patients with M1-MCA occlusion were included in this study. Clinical and procedural outcomes were analyzed according to the technique used and to the occlusion phenotype. RESULTS: 188 patients were included in the analysis (95 received SR, 93 CA as first-line treatment). The occlusion phenotypes were graded as irregular in 52.7% of cases (n=99, 95% CI 45.5% to 59.8%). In patients with an irregular occlusion phenotype, complete or adequate recanalization at the end of the first-line strategy was more often achieved with SR than CA (TICI 3: SR 44.1% vs CA 22.5%, OR 0.35, 95% CI 0.14 to 0.89, p=0.027), with a shorter procedure time, a lower number of passes (>2 passes: SR 32.2% vs CA 57.5%, OR 3.31, 95% CI 1.36 to 8.03, p=0.009), and higher rates of favorable clinical outcome (SR 55.2% vs CA 31.6%, OR 0.40, 95% CI 0.16 to 0.97, p=0.042). CONCLUSIONS: Irregular M1-MCA occlusion phenotypes treated with SR as first-line approach were associated with better procedural and clinical outcomes in the ASTER trial population.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
CHU Lille
Université de Lille
Université de Lille
Date de dépôt :
2019-12-09T16:48:02Z
2024-03-26T16:32:32Z
2024-03-26T16:32:32Z