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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

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학술저널
저자정보
Gaultier Marnat (University Hospital of Bordeaux) Igor Sibon (University Hospital of Bordeaux) Romain Bourcier (University Hospital of Nantes) Mohammad Anadani (Washington University School of Medicine) Florent Gariel (University Hospital of Bordeaux) Julien Labreuche (University of Lille) Maeva Kyheng (University of Lille) Mikael Mazighi (Rothschild Foundation) Cyril Dargazanli (CHRU Gui-de-Chauliac) Michel Piotin (Rothschild Foundation) Arturo Consoli (Versailles Saint-Quentin-en-Yvelines University) Raphaël Blanc (Rothschild Foundation) René Anxionnat (University of Lorraine CHRU-Nancy) Gérard Audibert (University of Lorraine University Hospital of Nancy) Sébastien Richard (University of Lorraine University Hospital of Nancy) Bertrand Lapergue (Versailles Saint-Quentin-en-Yvelines University) Benjamin Gory (University of Lorraine CHRU-Nancy) Behalf of ETIS and TITAN Investigators (Behalf of ETIS and TITAN Investigators)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제23권 제3호
발행연도
2021.9
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411 - 419 (9page)

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Background and Purpose Despite the widespread adoption of mechanical thrombectomy (MT) for the treatment of large vessel occlusion stroke (LVOS) in the anterior circulation, the optimal strategy for the treatment tandem occlusion related to cervical internal carotid artery (ICA) dissection is still debated. This individual patient pooled analysis investigated the safety and efficacy of prior intravenous thrombolysis (IVT) in anterior circulation tandem occlusion related to cervical ICA dissection treated with MT. Methods We performed a retrospective analysis of two merged prospective multicenter international real-world observational registries: Endovascular Treatment in Ischemic Stroke (ETIS) and Thrombectomy In TANdem occlusions (TITAN) registries. Data from MT performed in the treatment of tandem LVOS related to cervical ICA dissection between January 2012 and December 2019 at 24 comprehensive stroke centers were analyzed. The primary endpoint was a favorable outcome defined as 90-day modified Rankin Scale (mRS) score of 0?2. Results The study included 144 patients with tandem occlusion LVOS due to cervical ICA dissection, of whom 94 (65.3%) received IVT before MT. Prior IVT was significantly associated with a better clinical outcome considering the mRS shift analysis (common odds ratio, 2.59; 95% confidence interval [CI], 1.35 to 4.93; P=0.004 for a 1-point improvement) and excellent outcome (90-day mRS 0?1) (adjusted odds ratio [aOR], 4.23; 95% CI, 1.60 to 11.18). IVT was also associated with a higher rate of intracranial successful reperfusion (83.0% vs. 64.0%; aOR, 2.70; 95% CI, 1.21 to 6.03) and a lower rate of symptomatic intracranial hemorrhage (4.3% vs. 14.8%; aOR, 0.21; 95% CI, 0.05 to 0.80). Conclusions Prior IVT before MT for the treatment of tandem occlusion related to cervical ICA dissection was safe and associated with an improved 90-day functional outcome.
#Stroke #Internal carotid artery #Dissection #Reperfusion #Thrombolytic therapy

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참고문헌 (18)

참고문헌 신청
Goyal M / 2016 / Endovascular thrombectomy after large-vessel ischaemic stroke : a meta-analysis of individual patient data from five randomised trials / Lancet 387:1723~1731 google schola Yang P / 2020 / Endovascular thrombectomy with or without intravenous alteplase in acute stroke / N Engl J Med 382:1981~1993 google schola Suzuki K / 2021 / Effect of mechanical thrombectomy without vs with intravenous thrombolysis on functional outcome among patients with acute ischemic stroke : the SKIP randomized clinical trial / JAMA 325:244~253 google schola Zi W / 2021 / Effect of endovascular treatment alone vs intravenous alteplase plus endovascular treatment on functional independence in patients with acute ischemic stroke : the DEVT randomized clinical trial / JAMA 325:234~243 google schola Treurniet KM / 2021 / MR CLEAN-NO IV : intravenous treatment followed by endovascular treatment versus direct endovascular treatment for acute ischemic stroke caused by a proximal intracranial occlusion-study protocol for a randomized clinical trial / Trials 22:141 google schola

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