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Impact of Reperfusionfor NonagenariansTreated by MechanicalThrombectomy Eve Drouard-de RousiersLudovic LucasSébastien Richard2019 год

Impact of Reperfusion for Nonagenarians Treated by Mechanical Thrombectomy
статья из журнала

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Аннотация: Background and Purpose— Nonagenarians represent a growing stroke population characterized by a higher frailty. Although endovascular therapy (ET) is a cornerstone of the management of acute ischemic stroke related to large vessel occlusion, the benefit of reperfusion among nonagenarians is poorly documented. We aimed to assess the impact of ET-related reperfusion on the functional outcome of reperfusion in this elderly population. Methods— A retrospective analysis of clinical and imaging data from all patients aged over 90 included in the ETIS (Endovascular Treatment in Ischemic Stroke) registry between October 2013 and April 2018 was performed. Association between post-ET reperfusion and favorable (modified Rankin Scale [0–2] or equal to prestroke value) and good (modified Rankin Scale [0–3] or equal to prestroke value) outcome were evaluated. Demographic and procedural predictors of functional outcome, including the first-pass effect, were evaluated. Results were adjusted for center, admission National Institutes of Health Stroke Scale, and use of intravenous thrombolysis. Results— Among the 124 nonagenarians treated with ET, those with successful reperfusion had the lowest 90-day modified Rankin Scale (odds ratio, 3.26; 95% CI, 1.04–10.25). Only patients with successful reperfusion after the first pass (n=53, 56.7%) had a reduced 90-day mortality (odds ratio, 0.15; 95% CI, 0.05–0.45) and an increased rate of good outcome (odds ratio, 4.55; 95% CI, 1.38–15.03). No increase in the rate of intracranial hemorrhage was observed among patients successfully reperfused. Conclusions— Successful reperfusion improves the functional outcome of nonagenarians who should not be excluded from ET. The first-pass effect should be considered in the procedural management of this frail population.
Год издания: 2019
Авторы: Eve Drouard-de Rousiers, Ludovic Lucas, Sébastien Richard, Arturo Consoli, Mikaël Mazighi, Julien Labreuche, Maëva Kyheng, Benjamin Gory, Cyril Dargazanli, Caroline Arquizan, Gaultier Marnat, Raphaël Blanc, Hubert Desal, Romain Bourcier, Igor Sibon, Bertrand Lapergue, Michel Piotin, Raphaël Blanc, Hocine Redjem, Simon Escalard, Jean‐Philippe Desilles, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Mikaël Mazighi, Robert Fahed, Mikael Obadia, Candice Sabben, Ovide Corabianu, T. de Broucker, Didier Smadja, Sonia Alamowitch, Olivier Ille, Eric Manchon, Pierre‐Yves Garcia, Guillaume Taylor, Malek Ben Maacha, Adrien Wang, Serge Évrard, Maya Tchikviladzé, Vadim Afanasiev, Nadia Ajili, Bénédicte Sensenbrenner, Bertrand Lapergue, Oguzhan Coskun, Arturo Consoli, Federico Di Maria, Georges Rodesch, Bruno Del Sette, Riccardo Russo, Katsuhiro Mizutani, Morgan Leguen, Julie Gratieux, Fernando Pico, Haja Rakotoharinandrasana, Philippe Tassan, Roxanna Poll, Norbert Nighoghossian, Roberto Riva, Omer Eker, Françis Turjman, Laurent Derex, Tae‐Hee Cho, Laura Mechtouff, Anne Claire Lukaszewicz, Frédéric Philippeau, Serkan Cakmak, Karine Blanc‐Lasserre, Anne‐Evelyne Vallet, Gaultier Marnat, Florent Gariel, Xavier Barreau, Jérôme Berge, Louis Veunac, Patrice Menegon, Igor Sibon, Ludovic Lucas, Stéphane Olindo, Pauline Renou, Sharmila Sagnier, Mathilde Poli, Sabrina Debruxelles, Romain Bourcier, Lili Détraz, Benjamin Daumas-Duport, Pierre-Louis Alexandre, Monica Roy, Cédric Lenoble, Vincent L’Allinec, Jean-Baptiste Girot, Hubert Desal, Solène de Gaalon, Benoît Guillon, Benjamin Gory, Serge Bracard, René Anxionnat, Marc Braun, Anne‐Laure Derelle, Romain Tonnelet, Liang Liao, François Zhu, Emmanuelle Schmitt, Sophie Planel, Sébastien Richard, Lisa Humbertjean, Gioia Mione, Jean-Christophe Lacour, Mathieu Bonnerot, Nolwenn Riou-Comte, Isabelle Katherinne Fernandes Costa, Anne Chatelain, Vincent Costalat, Caroline Arquizan, Cyril Dargazanli, Grégory Gascou, Pierre-Henri Lefèvre, Imad Derraz, Carlos Riquelme, Nicolas Gaillard, Isabelle Mourand et Lucas Corti, Eugene François, Stéphane Vannier
Издательство: Lippincott Williams & Wilkins
Источник: Stroke
Ключевые слова: Acute Ischemic Stroke Management, Stroke Rehabilitation and Recovery, Traumatic Brain Injury and Neurovascular Disturbances
Другие ссылки: Stroke (HTML)
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