Influence of prior intravenous thrombolysis in patients treated with mechanical thrombectomy for M2 occlusions: insight from the Endovascular Treatment in Ischemic Stroke (ETIS) registry.

    Auteurs
  • Agathe Le Floch
  • Frédéric Clarençon
  • Aymeric Rouchaud
  • Maeva Kyheng
  • Julien Labreuche
  • Igor Sibon
  • Gregoire Boulouis
  • Benjamin Gory
  • Sébastien Richard
  • Jildaz Caroff
  • Raphaël Blanc
  • Pierre Seners
  • Omer F Eker
  • Tae-Hee Cho
  • Arturo Consoli
  • Romain Bourcier
  • Benoit Guillon
  • Cyril Dargazanli
  • Caroline Arquizan
  • Christian Denier
  • Francois Eugene
  • Stephane Vannier
  • Jean-Christophe Gentric
  • Maxime Gauberti
  • Olivier Naggara
  • Charlotte Rosso
  • Guillaume Turc
  • Ozlem Ozkul-Wermester
  • Christophe Cognard
  • Jean François Albucher
  • Serge Timsit
  • Frederic Bourdain
  • Anthony Le Bras
  • Sebastian Richter
  • Solène Moulin
  • Raoul Pop
  • Olivier Heck
  • Ricardo Moreno
  • Vincent L'Allinec
  • Bertrand Lapergue
  • Gaultier Marnat
  • Bertrand Lapergue
  • Adrien Wang
  • Arturo Consoli
  • Oguzhan Coskun
  • Federico Di Maria
  • Silvia Pizzuto
  • Alessandro Sgreccia
  • Charline Benoit
  • Lucas Gorza
  • David Weisenburger-Lile
  • Waliyde Jabeur
  • Tchikviladze Maia
  • Serge Evrard
  • Georges Rodesch
  • Raphaël Blanc
  • Jean-Philippe Desilles
  • Michel Piotin
  • Stanislas Smajda
  • Simon Escalard
  • Benjamin Maier
  • Hocine Redjem
  • Mikael Mazhigi
  • François Delvoye
  • Amira Al Raaisi
  • William Boisseau
  • Omer Eker
  • Tae-Hee Cho
  • Laurent Derex
  • Julia Fontaine
  • Laura Mechtouff
  • Norbert Nighoghossian
  • Elodie Ong
  • Lucie Rascle
  • Roberto Riva
  • Françis Turjman
  • Morgane Laubacher
  • Mehdi Beyragued
  • Yves Berthezene
  • Marc Hermier
  • Ameli Roxanna
  • Alexandre Bani-Sadr
  • Andrea Filip
  • Matteo Cappucci
  • Romain Bourcier
  • Benjamin Daumas Duport
  • Pierre Louis Alexandre
  • Cédric Lenoble
  • Hubert Desal
  • Solene De Gaalon
  • Benoît Guillon
  • Cécile Preterre
  • Guillaume Tessier
  • Arthur Lionnet
  • Benjamin Gory
  • Lisa Humbertjean-Selton
  • René Anxionnat
  • Anne-Laure Derelle
  • Liang Liao
  • Emmanuelle Schmitt
  • Sophie Planel
  • Sébastien Richard
  • Gioia Mione
  • Jean-Christophe Lacour
  • Marian Douarinou
  • Emilien Micard
  • Bailiang Chen
  • Gérard Audibert
  • Agnès Masson
  • Lionel Alb
  • Marine Beaumont
  • Adriana Tabarna
  • Marcela Voicu
  • Grégoire Barthel
  • Iona Podar
  • Madalina Brezeanu
  • Marie Reitter
  • François Zhu
  • Gaultier Marnat
  • Jean-Sébastien Liegey
  • Pierre Briau
  • Lisa Papillon
  • Igor Sibon
  • Xavier Barreau
  • Jean Papaxanthos
  • Jérome Berge
  • Sabrina Debruxelles
  • Stephane Olindo
  • Mathilde Poli
  • Pauline Renou
  • Sharmila Sagnier
  • Thomas Tourdias
  • Thomas Courret
  • Ludovic Lucas
  • Malgorzata Milnerowicz
  • Cyril Dargazanli
  • Vincent Costalat
  • Isabelle Mourand
  • Caroline Arquizan
  • Lucas Corti
  • Adrien Ter Schiphorst
  • Cagnazzo Federico
  • Imad Derraz
  • Mehdi Mahmoudi
  • Pierre-Henri Lefevre
  • Grégory Gascou
  • Laurent Spelle
  • Jildaz Caroff
  • Christian Denier
  • Vanessa Chalumeau
  • Cristian Mihalea
  • Nicolas Legris
  • Augustin Ozanne
  • Leon Ikka
  • Olivier Chassin
  • Sophie Gallas
  • Laura Venditti
  • Mariana Sarov
  • Jonathan Cortese
  • Jean-Christophe Ferre
  • Stephane Vannier
  • Thomas Ronziere
  • Maria Veronica Lassalle
  • Jean-Yves Gauvrit
  • Clément Tracol
  • Abdelghani Fakhreddine Boustia
  • Cécile Malrain
  • Edouard Beaufreton
  • Thibault Lapotre
  • Quentin Alias
  • Julien Hissier
  • Maud Guillen
  • François Eugene
  • Cyril Chivot
  • Audrey Courselle
  • Elisa Ouin
  • Chantal Lamy
  • Kevin Delaforge
  • Manuel Fernandez
  • Jérémie Vial
  • Quentin Laferte
  • Xavier Desdoit
  • Serge Timsit
  • Aurore Jourdain
  • Jean-Christophe Gentric
  • Julien Ognard
  • Irina Viakhireva
  • Jordan Coris
  • Sabine Prud'hon
  • François-Mathias Merrien
  • Denis Marechal
  • Marie Bruguet
  • Pierre Yves Rousseau
  • Philippe Goas
  • Marion Boulanger
  • Emmanuel Touze
  • Denis Vivien
  • Charlotte Barbier
  • Romain Schneckenburger
  • Fabrizio Salaris
  • Julien Cogez
  • Sophie Guettier
  • Estelle La Porte
  • Jean Bouchart
  • Charbel Mounayer
  • Aymeric Rouchaud
  • Suzana Saleme
  • Géraud Forestier
  • Frédéric Clarencon
  • Charlotte Rosso
  • Sara Leder
  • Flore Baronnet
  • Sophie Crozier
  • Anne Leger
  • Kevin Premat
  • Shotar Eimad
  • Stéphanie Lenck
  • Nader Sourour
  • Laure Bottin
  • Sam Ghazanfari
  • Marion Yger
  • Sonia Alamowitch
  • Stephen Delorme
  • Aymeric Wittwer
  • Christine Vassilev
  • Olivier Naggara
  • Guillaume Turc
  • Wagih Ben Hassen
  • Basile Kerleroux
  • Denis Trystram
  • Christine Rodriguez-Regent
  • Ozlem Ozkul-Wermester
  • Chrysanthi Papagiannaki
  • Evelyne Massardier
  • Aude Triquenot
  • Margaux Lefebvre
  • Julien Burel
  • Alain Viguier
  • Christophe Cognard
  • Anne Christine Januel
  • Jean-François Albucher
  • Lionel Calviere
  • Jean-Marc Olivot
  • Jean Darcourt
  • Nicolas Raposo
  • Fabrice Bonneville
  • Guillaume Bellanger
  • Louis Fontaine
  • Philippe Tall
  • Frédéric Bourdain
  • Patricia Bernady
  • Guillaume Ballan
  • Stephanie Bannier
  • Emmanuel Ellie
  • Olivier Flabeau
  • Julia Potenza
  • Antoine Soulages
  • Laurent Lagoarde-Segot
  • Hélène Cailliez
  • Louis Veunac
  • David Higue
  • Anthony Lebras
  • Sarah Adam
  • Benoit Pegat
  • Arnaud Le Guen
  • François Chedeville
  • Jérémy Jouan
  • Stéphanie Demasles
  • Johann Sebastian Richter
  • Bruno Thierry Barroso
  • Camille Dahan
  • Alexis Gonnet
  • Régis Hubrecht
  • Zoé Lepine
  • Hélène Castagnet
  • Raluca Marasescu
  • Olivier Heck
  • Pauline Cuisenier
  • Olivier Detante
  • Isabelle Favre Wiki
  • Clémentine Bonaz
  • Garambois Katia
  • Loic Legris
  • Adrian Kastler
  • Kamel Boubagra
  • Corentin Berthet
  • Stéphane Charara
  • Valérie Wolff
  • Raoul Pop
  • Véronique Quenardelle
  • Valérie Lauer
  • Irène Pierre-Paul
  • Roxana Gheoca
  • Malwina Trzeciak
  • Solène Moulin
  • Hua Vi Tuan
  • Paolo Pagano
  • Alexandre Doucet
  • Christophe Gelmini
  • Pierrefrançois Manceau
  • Laurentiu Paiusan
  • Isabelle Serre
  • Sébastien Soize
  • Thi Ngoc Phuong Nguyen
  • Maher Sahnoun
  • Nathalie Caucheteux
  • Anna Ferrier
  • Abderrahim Zerroug
  • Ricardo Moreno
  • Emmanuel Chabert
  • Elie Lteif
  • Pauline Paris
  • Nathalie Bourgois
  • Marie Raquin
  • Anne Pasco-Papon
  • Jean Baptiste Girot
  • Alderic Lecluse
  • Sophie Godard
  • Vincent L'allinec
  • Kevin Janot
  • Richard Bibi
  • Marie Gaudron
  • Arnaud Bretonniere
  • Mariam Annan
  • Héloïse Ifergan
  • Grégoire Boulouis
  • Marco Pasi
  • Séverine Debiais
  • Elisabeth Molinier
  • Anthony Wietrich
  • Valérie Ruche
  • Karine Lavandier
  • Yannick Bejot
  • Brivale Lemogne
  • Fédéric Ricolfi
  • Laura Baptiste
  • Pierre Thouant
  • Gaulthier Duloquin
  • Pierre Olivier Comby
  • Guillaume Charbonnier
  • Louise Bonnet
  • Nicolas Raybaud
  • Benjamin Bouamra
  • Thierry Moulin
  • Alessandra Biondi

Source: Journal (source)J Neurointerv Surg

Publié le Date de publication

Résumé

AbstractBACKGROUND: Intravenous thrombolysis (IVT) for patients treated with mechanical thrombectomy (MT) for proximal occlusions has recently been questioned through randomized trials. However, few patients with M2 occlusions were included. We investigated the influence of prior IVT for patients presenting M2 occlusions treated with MT in comparison with MT alone.

METHODS: We conducted a retrospective analysis of the Endovascular Treatment in Ischemic Stroke (ETIS) registry, a multicenter observational study. Data from consecutive patients treated with MT for M2 occlusions between January 2015 and January 2022 at 26 comprehensive stroke centers were analyzed. The primary endpoint was 90-day modified Rankin Scale score of 0-2. Outcomes were compared using propensity score approaches. We also performed sensitivity analysis in relevant subgroups of patients.

RESULTS: Among 1132 patients with M2 occlusions treated with MT, 570 received prior IVT. The two groups were comparable after propensity analysis. The rate of favorable functional outcome was significantly higher in the IVT+MT group compared with the MT alone group (59.8% vs 44.7%; adjusted OR 1.38, 95% CI 1.10 to 1.75, P=0.008). Hemorrhagic and procedural complications were similar in both groups. In sensitivity analysis excluding patients with anticoagulation treatment, favorable recanalization was more frequent in the IVT+MT group (OR 1.37, 95% CI 1.11 to 1.70, P=0.004).

CONCLUSIONS: In cases of M2 occlusions, prior IVT combined with MT resulted in better functional outcome than MT alone, without increasing the rate of hemorrhagic or procedural complications. These results suggest the benefit of IVT in patients undergoing MT for M2 occlusions.