Abstract WP10: Impact of Prior Intravenous Thrombolysis on the Outcome of Emergent Carotid Stenting in Acute Stroke Patients With Tandem Occlusion: A Collaborative Pooled Analysis
| Autor: | René Anxionnat, Sebastian Eiden, Salvatore Mangiafico, Marc Ribó, Diogo C Haussen, Benjamin Gory, Marc A Labeyrie, Monika Killer, Franziska Dorn, Bertrand Lapergue, Mohammad Anadani, Henrik Steglich-Arnholm, Marios Psychogios, Alejandro M Spiotta, Biondi Alessandra, Markus Holtmannspötter, Serge Bracard, Sébastien Richard, Christian Taschner, Michel Piotin, Mikael Mazighi, Christophe Cognard, Raul G Nogueira, Panagiotis Papanagiotou, Francis Turjman, Maria Boutchakova, Steven Lauzon, Adnan H. Siddiqui |
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| Přispěvatelé: | Medical University of South Carolina [Charleston] (MUSC), Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hospices Civils de Lyon (HCL), Rigshospitalet [Copenhagen], Copenhagen University Hospital, Freiburg University Medical Center, Emory University School of Medicine, Emory University [Atlanta, GA], Klinikum Bremen-Mitte, University at Buffalo [SUNY] (SUNY Buffalo), State University of New York (SUNY), Hôpital Foch [Suresnes], Klinikum der Universität [München], Neuroradiologie Diagnostique et Thérapeutique [Toulouse], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Paracelsus Medizinische Privatuniversität = Paracelsus Medical University (PMU), Azienda Ospedaliero-Universitaria Careggi (AOU Careggi), Vall d'Hebron University Hospital [Barcelona], University Medical Center Göttingen (UMG), Service de Neuroradiologie [CHU Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Occlusion medicine [INFO.INFO-IM]Computer Science [cs]/Medical Imaging Stroke ComputingMilieux_MISCELLANEOUS Acute stroke Advanced and Specialized Nursing business.industry Stent Thrombolysis medicine.disease Pooled analysis Cardiology Neurology (clinical) Carotid stenting Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Zdroj: | Stroke Stroke, American Heart Association, 2019, 50 (Suppl 1), ⟨10.1161/str.50.suppl_1.WP10⟩ |
| ISSN: | 0039-2499 1524-4628 |
| DOI: | 10.1161/str.50.suppl_1.WP10⟩ |
| Popis: | Background: Acute tandem occlusion (ATO) management is technically challenging and was not sufficiently evaluated in trials. There is evidence suggesting the efficacy and safety of emergent carotid stenting in conjunction with mechanical thrombectomy (MT) for ATO treatment. However, the safety of carotid stenting (CS) post intravenous tPA (IVT) treatment remains unclear. Objective: to report the safety and functional outcomes of emergent CS post IVT, and compare it to non-IVT patients. Methods: This was a retrospective multicenter international TITAN collaboration including 18 endovascular databases. In the present analysis, patients were included if they presented with acute ischemic stroke (AIS) due to ATO and were treated with CS in conjunction with MT. ATO was defined as an extracranial internal carotid artery (ICA) lesion (complete occlusion or stenosis >=90%) and an intracranial proximal occlusion (distal ICA and/or first or second segment of the middle cerebral artery). Outcome measures included final mTICI score, 90 day-modified Rankin Scale (mRS), mortality, procedural complications, and symptomatic intracerebral hemorrhage. Mixed effects logistic model was used to determine the predictors of each outcome Results: Among 454 patients with ATO, 289 were treated with CS and included in the present analysis. One hundred seventy-five patients (60%) of the included patients received IVT prior to MT. Onset to groin was shorter in the IVT group (259 ±251 vs. 353±238; p=0.013). Otherwise, there was no difference in baseline characteristics between the two groups. Heparin use during procedure was less in IVT group (20% vs. 54%; p Conclusion: Emergent CS in association with MT after IVT was safe and was not associated with an increased risk of sICH or procedural complications. |
| Databáze: | OpenAIRE |
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