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Endovascular Therapy or Medical Management Alone for Isolated Posterior Cerebral Artery Occlusion: A Multicenter Study

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Název: Endovascular Therapy or Medical Management Alone for Isolated Posterior Cerebral Artery Occlusion: A Multicenter Study
Autoři: Candice Sabben, Frédérique Charbonneau, François Delvoye, Davide Strambo, Mirjam R. Heldner, Elodie Ong, Adrien Ter Schiphorst, Hilde Henon, Wagih Ben Hassen, Thomas Agasse-Lafont, Loïc Legris, Igor Sibon, Valérie Wolff, Denis Sablot, Mahmoud Elhorany, Cécile Preterre, Nour Nehme, Sébastien Soize, David Weisenburger-Lile, Aude Triquenot-Bagan, Gioia Mione, Andreea Aignatoaie, Jérémie Papassin, Roxana Poll, Yannick Béjot, Emmanuel Carrera, Pierre Garnier, Patrik Michel, Guillaume Saliou, Pasquale Mordasini, Yves Berthezene, Vincent Costalat, Nicolas Bricout, Gregory W. Albers, Mikael Mazighi, Guillaume Turc, Pierre Seners, Kateryna Antonenko, Caroline Arquizan, Lynda Benammar, Claire Boutet, Frédéric Clarençon, Pierre-Olivier Comby, Hubert Desal, Olivier Detante, François Eugene, Emmanuel Gerardin, Benjamin Gory, Stéphane Kremer, Sylvain Ledure, Mathieu Krug, Bertrand Lapergue, Philippe Niclot, Christophe Magni, Michael Obadia, Canan Ozsancak, Fernando Pico, Sara Pilgram-Pastor, Raoul Pop, Sébastien Richard, Charlotte Rosso, Julien Savatovsky, Solène Moulin, Clément Tracol, Martin Zbinden
Přispěvatelé: CarMeN, laboratoire, Fondation Ophtalmologique Adolphe de Rotschild, Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital Lausanne (CHUV), Université de Lausanne = University of Lausanne (UNIL), Universität Bern = University of Bern = Université de Berne (UNIBE), Bern University Hospital Berne (Inselspital), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Hôpital Gui de Chauliac CHU Montpellier, Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Lille Neurosciences & Cognition - U 1172 (LilNCog), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille), Groupe hospitalier universitaire Paris psychiatrie & neurosciences Paris (GHU Paris Psychiatrie et Neurosciences), Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Pontchaillou, Université Grenoble Alpes (UGA), GIN Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Université de Bordeaux (UB), Université de Strasbourg (UNISTRA), Centre Hospitalier Saint Jean de Perpignan, CHU Pitié-Salpêtrière AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Tanta University, Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes), Centre Hospitalier de Versailles André Mignot (CHV), Hôpital universitaire Robert Debré Reims (CHU Reims), Hémostase et Remodelage Vasculaire Post-Ischémie (HERVI - EA 3801), Université de Reims Champagne-Ardenne (URCA), Hôpital Foch Suresnes, CHU Rouen, Normandie Université (NU), Service de Chirurgie Cardio-vasculaire CHRU Nancy, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional d'Orléans (CHRO), Centre Hospitalier Métropole Savoie Chambéry, Centre Hospitalier René Dubos Pontoise, Physiopathologie et épidémiologie cérébro-cardiovasculaires Dijon (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté COMUE (UBFC), Department of Neurology Genève, Hôpitaux Universitaires de Genève (HUG), Service de Neurologie CHU de Saint-Étienne, Centre Hospitalier Universitaire de Saint-Etienne CHU Saint-Etienne (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM), Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Modeling & analysis for medical imaging and Diagnosis (MYRIAD), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital neurologique et neurochirurgical Pierre Wertheimer CHU - HCL, Neuroradiologie Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Stanford University, Fondation Ophtalmologique Adolphe de Rothschild Paris, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpital Lariboisière-Fernand-Widal APHP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), FHU NeuroVasc Site Sainte-Anne, Paris (GHU-PPN), Centre Hospitalier Sainte Anne Paris, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), ACAPULCO Collaborators: Kateryna Antonenko, Caroline Arquizan, Lynda Benammar, Claire Boutet, Frédéric Clarençon, Pierre-Olivier Comby, Hubert Desal, Olivier Detante, François Eugene, Emmanuel Gerardin, Benjamin Gory, Stéphane Kremer, Sylvain Ledure, Mathieu Krug, Bertrand Lapergue, Philippe Niclot, Christophe Magni, Michael Obadia, Canan Ozsancak, Fernando Pico, Sara Pilgram-Pastor, Raoul Pop, Sébastien Richard, Charlotte Rosso, Julien Savatovsky, Solène Moulin, Clément Tracol, Martin Zbinden.
Zdroj: Sabben, Candice; Charbonneau, Frédérique; Delvoye, François; Strambo, Davide; Heldner, Mirjam R.; Ong, Elodie; Ter Schiphorst, Adrien; Henon, Hilde; Ben Hassen, Wagih; Agasse-Lafont, Thomas; Legris, Loïc; Sibon, Igor; Wolff, Valérie; Sablot, Denis; Elhorany, Mahmoud; Preterre, Cécile; Nehme, Nour; Soize, Sébastien; Weisenburger-Lile, David; Triquenot-Bagan, Aude; ... (2023). Endovascular Therapy or Medical Management Alone for Isolated Posterior Cerebral Artery Occlusion: A Multicenter Study. Stroke, 54(4), pp. 928-937. American Heart Association 10.1161/STROKEAHA.122.042283 <http://dx.doi.org/10.1161/STROKEAHA.122.042283>
Informace o vydavateli: Ovid Technologies (Wolters Kluwer Health), 2023.
Rok vydání: 2023
Témata: Male, 616.8, [SDV]Life Sciences [q-bio], 610 Medicine & health, Intracranial hemorrhage, cerebral arteries, ischemia, Stroke/therapy, Sciences de la santé humaine, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, Ischemia, Neurologie, Brain Ischemia / surgery, ischemic stroke, Humans, Thrombolytic Therapy, Human health sciences, Aged, Ischemic Stroke, Thrombectomy, Advanced and Specialized Nursing, Aged, 80 and over, Posterior Cerebral Artery, Ischemic stroke, Cerebral arteries, Endovascular Procedures, Middle Aged, 3. Good health, thrombectomy, [SDV] Life Sciences [q-bio], Stroke, Brain Ischemia/surgery, Treatment Outcome, Neurology, Stroke / therapy, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, Intracranial Hemorrhages, intracranial hemorrhage
Popis: Background: Whether endovascular therapy (EVT) added on best medical management (BMM), as compared to BMM alone, is beneficial in acute ischemic stroke with isolated posterior cerebral artery occlusion is unknown. Methods: We conducted a multicenter international observational study of consecutive stroke patients admitted within 6 hours from symptoms onset in 26 stroke centers with isolated occlusion of the first (P1) or second (P2) segment of the posterior cerebral artery and treated either with BMM+EVT or BMM alone. Propensity score with inverse probability of treatment weighting was used to account for baseline between-groups differences. The primary outcome was 3-month good functional outcome (modified Rankin Scale [mRS] score 0–2 or return to baseline modified Rankin Scale). Secondary outcomes were 3-month excellent recovery (modified Rankin Scale score 0–1), symptomatic intracranial hemorrhage, and early neurological deterioration. Results: Overall, 752 patients were included (167 and 585 patients in the BMM+EVT and BMM alone groups, respectively). Median age was 74 (interquartile range, 63–82) years, 329 (44%) patients were female, median National Institutes of Health Stroke Scale was 6 (interquartile range 4–10), and occlusion site was P1 in 188 (25%) and P2 in 564 (75%) patients. Baseline clinical and radiological data were similar between the 2 groups following propensity score weighting. EVT was associated with a trend towards lower odds of good functional outcome (odds ratio, 0.81 [95% CI, 0.66–1.01]; P =0.06) and was not associated with excellent functional outcome (odds ratio, 1.17 [95% CI, 0.95–1.43]; P =0.15). EVT was associated with a higher risk of symptomatic intracranial hemorrhage (odds ratio, 2.51 [95% CI, 1.35–4.67]; P =0.004) and early neurological deterioration (odds ratio, 2.51 [95% CI, 1.64–3.84]; P Conclusions: In this observational study of patients with proximal posterior cerebral artery occlusion, EVT was not associated with good or excellent functional outcome as compared to BMM alone. However, EVT was associated with higher rates of symptomatic intracranial hemorrhage and early neurological deterioration. EVT should not be routinely recommended in this population, but randomization into a clinical trial is highly warranted.
Druh dokumentu: Article
Other literature type
Popis souboru: application/pdf
Jazyk: English
ISSN: 1524-4628
0039-2499
DOI: 10.1161/strokeaha.122.042283
DOI: 10.48350/189666
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/36729389
https://inserm.hal.science/inserm-04314014v1
https://doi.org/10.1161/strokeaha.122.042283
https://inserm.hal.science/inserm-04314014v1/document
https://boris.unibe.ch/189666/
Přístupové číslo: edsair.doi.dedup.....7da8c33ed2c16879ec7e8f0b4de5921f
Databáze: OpenAIRE
Popis
Abstrakt:Background: Whether endovascular therapy (EVT) added on best medical management (BMM), as compared to BMM alone, is beneficial in acute ischemic stroke with isolated posterior cerebral artery occlusion is unknown. Methods: We conducted a multicenter international observational study of consecutive stroke patients admitted within 6 hours from symptoms onset in 26 stroke centers with isolated occlusion of the first (P1) or second (P2) segment of the posterior cerebral artery and treated either with BMM+EVT or BMM alone. Propensity score with inverse probability of treatment weighting was used to account for baseline between-groups differences. The primary outcome was 3-month good functional outcome (modified Rankin Scale [mRS] score 0–2 or return to baseline modified Rankin Scale). Secondary outcomes were 3-month excellent recovery (modified Rankin Scale score 0–1), symptomatic intracranial hemorrhage, and early neurological deterioration. Results: Overall, 752 patients were included (167 and 585 patients in the BMM+EVT and BMM alone groups, respectively). Median age was 74 (interquartile range, 63–82) years, 329 (44%) patients were female, median National Institutes of Health Stroke Scale was 6 (interquartile range 4–10), and occlusion site was P1 in 188 (25%) and P2 in 564 (75%) patients. Baseline clinical and radiological data were similar between the 2 groups following propensity score weighting. EVT was associated with a trend towards lower odds of good functional outcome (odds ratio, 0.81 [95% CI, 0.66–1.01]; P =0.06) and was not associated with excellent functional outcome (odds ratio, 1.17 [95% CI, 0.95–1.43]; P =0.15). EVT was associated with a higher risk of symptomatic intracranial hemorrhage (odds ratio, 2.51 [95% CI, 1.35–4.67]; P =0.004) and early neurological deterioration (odds ratio, 2.51 [95% CI, 1.64–3.84]; P Conclusions: In this observational study of patients with proximal posterior cerebral artery occlusion, EVT was not associated with good or excellent functional outcome as compared to BMM alone. However, EVT was associated with higher rates of symptomatic intracranial hemorrhage and early neurological deterioration. EVT should not be routinely recommended in this population, but randomization into a clinical trial is highly warranted.
ISSN:15244628
00392499
DOI:10.1161/strokeaha.122.042283