| Title: |
Successful Thrombectomy Improves Functional Outcome in Tandem Occlusions with a Large Ischemic Core |
| Authors: |
Gory, Benjamin; Finitsis, Stephanos Nikolaos; Desilles, Jean Philippe; Consoli, Arturo; Mazighi, Mikael; Marnat, Gaultier; Sibon, Igor; Pop, Raoul; Raposo, Nicolas; Wolff, Valérie; Cognard, Christophe H.; Richard, Sébastien; Moulin, Solène; Soize, Sébastien; Lapergue, Bertrand; Wang, Adrien; Coskun, Oguzhan; Maria, Federico; Pizzuto, Silvia; Sgreccia, Alessandro; Benoit, Charline; Gorza, Lucas; Weisenburger-Lile, David; Jabeur, Waliyde; Maia, Tchikviladze; Evrard, Serge; Rodesch, Georges L.; Blanc, Raphaël; Obadia, Michaël Alexandre; Piotin, Michel P.; Seners, Pierre; Smajda, Stanislas J.; Escalard, Simon; Maier, Benjamin; Sabben, Candice; Redjem, Hocine; Adwan, Grace; Delvoye, François; Raaisi, Amira Al; Boisseau, William; Eker, Omer Faruk; Cho, Tae-Hee; Derex, Laurent; Fontaine, Julia; Mechtouff, Laura; Nighoghossian, Norbert; Ong, Elodie; Rascle, Lucie; Riva, Roberto; Turjman, Françis; Laubacher, Morgane; Beyragued, Mehdi; Berthezene, Yves; Hermier, Marc R.; Roxanna, Ameli; Bani-Sadr, Alexandre; Filip, Andrea; Cappucci, Matteo; Bourcier, Romain; Duport, Benjamin Daumas; Alexandre, Pierre Louis; Lenoble, Cédric; Gaalon, Solène De; Guillon, Benoît; Preterre, Cécile; Tessier, Guillaume; Lionnet, Arthur; Humbertjean-Selton, Lisa; Anxionnat, René; Derelle, Anne Laure; Liao, Liang; Schmitt, Emmanuelle; Planel, Sophie; Mione, Gioia; Lacour, Jean Christophe; Douarinou, Marian; Micard, Emilien; Chen, Bailiang; Audibert, Gérard; Masson, Agnès; Alb, Lionel; Beaumont, Marine; Tabarna, Adriana; Voicu, Marcela; Barthel, Grégoire; Podar, Iona; Brezeanu, Madalina; Reitter, Marie; Zhu, François; Liegey, Jean Sébastien; Briau, Pierre; Papillon, Lisa; Barreau, Xavier; Papaxanthos, Jean; Berge, Jerome; Debruxelles, Sabrina; Olindo, Stéphane; Poli, Mathilde; Renou, Pauline; Sagnier, Sharmila; Tourdias, Thomas; Courret, Thomas; Lucas, Ludovic; Milnerowicz, Maĺgorzata; Dargazanli, Cyril; Costalat, Vincent; Mourand, Isabelle; Arquizan, Caroline; Corti, Lucas; Schiphorst, Ter; Federico, Cagnazzo; Derraz, Imad; Mahmoudi, Mehdi; Lefevre, Pierre Henri; Gascou, Grégory; Spelle, Laurent; Caroff, Jildaz; Denier, Christian; Chalumeau, Vanessa; Mihalea, Cristian; Ozanne, Augustin P.; Ikka, Léon; Chassin, Olivier; Gallas, Sophie; Venditti, Laura; Cortese, Jonathan; Ferre, Jean Christophe; Vannier, Stéphane; Ronziere, Thomas; Veronica Lassalle, Maria; Gauvrit, Jean Yves; Tracol, Clément; Boustia, Abdelghani Fakhreddine; Malrain, Cécile; Beaufreton, Edouard; Lapotre, Thibaut; Alias, Quentin; Hissier, Julien; Guillen, Maud; Eugene, François; Chivot, Cyril; Courselle, Audrey; Ouin, Elisa; Lamy, Chantal; Delaforge, Kévin; Fernandez, Manuel; Vial, Jérémie; Laferte, Quentin; Desdoit, Xavier; Timsit, Serge; Jourdain, Aurore; Gentric, Jean Christophe; Ognard, J.; Viakhireva, Irina; Coris, Jordan; Prud'Hon, Sabine; Merrien, François Mathias; Marechal, Denis; Bruguet, Marie; Rousseau, Pierre Yves; Goas, Philippe; Boulanger, Marion; Touze, Emmanuel; Vivien, Denis; Barbier, Charlotte N.; Schneckenburger, Romain; Salaris, Fabrizio; Cogez, Julien; Guettier, Sophie; Porte, Estelle La; Bouchart, Jean; Mounayer, Charbel; Rouchaud, Aymeric M.; Saleme, Suzana; Forestier, Géraud; Clarencon, Frédéric; Rosso, Charlotte; Leder, Sara Julia; Baronnet, Flore; Crozier, Sophie; Leger, Anne; Premat, Kévin; Eimad, Shotar; Lenck, Stéphanie; Sourour, Nader Antoine; Bottin, Laure; Ghazanfari, Sam; Yger, Marion; Alamowitch, Sonia; Delorme, Stephen; Wittwer, Aymeric; Vassilev, Christine; Naggara, Olivier N.; Turc, G.; Hassen, Wagih Ben; Kerleroux, Basile; Trystram, Denis; Rodriguez-Regent, Christine; Ozkul-Wermester, Ozlem; Papagiannaki, Chrysanthi; Massardier, Evelyne Guégan; Triquenot, Aude Bagan; Lefebvre, Margaux; Burel, Julien; Viguier, Alain; Januel, Anne Christine; Albucher, Jean François; Calviere, Lionel; Darcourt, Jean; Bonneville, Fabrice; Bellanger, Guillaume; Tall, Philippe; Thalamas, Claire; Geerearts, Thomas; Grepon, Antoine Faurie; Bourdain, Frédéric D.Ric; Bernady, Patricia; Ballan, Guillaume; Bannier, Stéphanie; Ellie, Emmanuel; Flabeau, Olivier; Potenza, Julia; Soulages, Antoine; Lagoarde-Segot, Laurent; Cailliez, Hélène; Higue, David; Veunac, Louis; Lebras, Anthony; Adam, Sarah; Pegat, Benoit; Guen, Arnaud Le; Chedeville, François; Jouan, Jérémy; Demasles, Stéphanie; Richter, Johann Sebastian; Thierry Barroso, Bruno; Dahan, Camille; Gonnet, Alexis; Hubrecht, Régis; Lepine, Zoé; Castagnet, Hélène; Marasescu, Raluca; Heck, Olivier; Cuisenier, Pauline; Detante, Olivier; Wiki, Isabelle Favre; Bonaz, Clémentine; Garambois, Katia; Legris, Loïc; Kastler, Adrian; Boubagra, Kamel; Berthet, Corentin; Charara, Stéphane; Quenardelle, Véronique; Lauer, Valérie; Pierre-Paul, Irène Nora; Trzeciak, Malwina; Tuan, Hua Vi; Pagano, Paolo; Doucet, Alexandre; Gelmini, Christophe; Manceau, Pierre François; Paiusan, Laurentiu; Serre, Isabelle; Phuong Nguyen, Thi Ngoc; Sahnoun, Maher; Caucheteux, Nathalie; Ferrier, Anna; Zerroug, Abderrahim; Moreno, Ricardo; Chabert, Emmanuel; Lteif, Elie; Bourgois, Nathalie; Raquin, Marie; Pasco-Papon, Anne; Girot, Jean Baptiste; Lecluse, Aldéric; Godard, Sophie; l'Allinec, Vincent; Janot, Kévin; Bibi, Richard Edwige; Gaudron, Marie; Bretonniere, Arnaud; Annan, Mariam; Ifergan, Héloïse; Boulouis, Grégoire; Pasi, Marco; Debiais, Séverine; Molinier, Elisabeth; Wietrich, Anthony; Ruche, Valérie; Lavandier, Karine; Bejot, Yannick; Lemogne, Brivale; Ricolfi, Fédéric; Baptiste, Laura; Thouant, Pierre; Duloquin, Gauthier; Olivier Comby, Pierre; Charbonnier, Guillaume; Bonnet, Louise; Raybaud, Nicolas; Bouamra, Benjamin; Moulin, T.; Biondi, Alessandra; Olivot, Jean-Marc |
| Contributors: |
Imagerie Adaptative Diagnostique et Interventionnelle (IADI); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL); Département de neuroradiologie diagnostique et thérapeutique CHRU Nancy; Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy); AHEPA University General Hospital Thessaloniki; CHU Rothschild AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ); Hôpital Foch Suresnes; Centre Hospitalier Universitaire de Bordeaux (CHU Bordeaux); Centre Hospitalier Universitaire Strasbourg (CHU Strasbourg); Hôpitaux Universitaires de Strasbourg (HUS); Département Neurologie CHU Toulouse; Pôle Neurosciences CHU Toulouse; Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse); Toulouse NeuroImaging Center (ToNIC); Université Toulouse III - Paul Sabatier (UT3); Communauté d'universités et établissements de Toulouse (Comue de Toulouse)-Communauté d'universités et établissements de Toulouse (Comue de Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI); Université Toulouse - Jean Jaurès (UT2J); Communauté d'universités et établissements de Toulouse (Comue de Toulouse)-Communauté d'universités et établissements de Toulouse (Comue de Toulouse)-Université Toulouse III - Paul Sabatier (UT3); Communauté d'universités et établissements de Toulouse (Comue de Toulouse)-Université Toulouse - Jean Jaurès (UT2J); Communauté d'universités et établissements de Toulouse (Comue de Toulouse)-Université Toulouse III - Paul Sabatier (UT3); Communauté d'universités et établissements de Toulouse (Comue de Toulouse); Mitochondrie, Stress oxydant et Protection musculaire (MSP); Université de Strasbourg (UNISTRA); Service Neuroradiologie Diagnostique et Thérapeutique CHU Toulouse; Pôle imagerie médicale CHU Toulouse; Service de neurologie CHRU Nancy; Défaillance Cardiovasculaire Aiguë et Chronique (DCAC); Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL); Hôpital universitaire Robert Debré Reims (CHU Reims); UFR Sciences de la santé Simone Veil (UVSQ Santé); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Saclay; Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE); Institut du Cerveau = Paris Brain Institute (ICM); Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS); Maladies neurodéveloppementales et neurovasculaires (NeuroDiderot (UMR_S_1141 / U1141)); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité); Institut Bergonié Bordeaux; UNICANCER; Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Fondation Ophtalmologique Adolphe de Rothschild Paris; Génétique, génomique fonctionnelle et biotechnologies (UMR 1078) (GGB); Établissement Français du Sang La Plaine Saint-Denis (EFS)-Université de Brest (UBO EPE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM); Université de Brest (UBO EPE) |
| Source: |
ISSN: 1878-8750. |
| Publisher Information: |
CCSD; Elsevier |
| Publication Year: |
2023 |
| Collection: |
Université Toulouse III - Paul Sabatier: HAL-UPS |
| Subject Terms: |
Outcome; Reperfusion; Safety; Stroke; Tandem occlusion; Thrombectomy; [SDV]Life Sciences [q-bio] |
| Description: |
International audience ; Background: Emergent stenting in tandem occlusions and mechanical thrombectomy (MT) of acute ischemic stroke related to large vessel occlusion (LVO-AIS) with a large core are tested independently. We aim to assess the impact of reperfusion with MT in patients with LVO-AIS with a large core and a tandem occlusion and to compare the safety of reperfusion between large core with tandem and nontandem occlusions in current practice. Methods: We analyzed data of all consecutive patients included in the prospective Endovascular Treatment in Ischemic Stroke Registry in France between January 2015 and March 2023 who presented with a pretreatment ASPECTS (Alberta Stroke Program Early CT Score) of 0–5 and angiographically proven tandem occlusion. The primary end point was a favorable outcome defined by a modified Rankin Scale (mRS) score of 0–3 at 90 days. Results: Among 262 included patients with a tandem occlusion and ASPECTS 0–5, 203 patients (77.5%) had a successful reperfusion (modified Thrombolysis in Cerebral Infarction grade 2b-3). Reperfused patients had a favorable shift in the overall mRS score distribution (adjusted odds ratio [aOR], 1.57 [1.22–2.03]; P < 0.001), higher rates of mRS score 0–3 (aOR, 7.03 [2.60–19.01]; P < 0.001) and mRS score 0–2 at 90 days (aOR, 3.85 [1.39–10.68]; P = 0.009) compared with nonreperfused. There was a trend between the occurrence of successful reperfusion and a decreased rate of symptomatic intracranial hemorrhage (aOR, 0.5 [0.22–1.13]; P = 0.096). Similar safety outcomes were observed after large core reperfusion in tandem and nontandem occlusions. Conclusions: Successful reperfusion was associated with a higher rate of favorable outcome in large core LVO-AIS with a tandem occlusion, with a safety profile similar to nontandem occlusion. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/37473866; PUBMED: 37473866 |
| DOI: |
10.1016/j.wneu.2023.07.043 |
| Availability: |
https://hal.science/hal-04195189; https://hal.science/hal-04195189v1/document; https://hal.science/hal-04195189v1/file/Gory2023.pdf; https://doi.org/10.1016/j.wneu.2023.07.043 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.5117F537 |
| Database: |
BASE |