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12. General anesthesia or conscious sedation for endovascular therapy of basilar artery occlusions: ETIS registry results

Author

Skutecki, J., primary, Audibert, G., additional, Finitsis, S., additional, Consoli, A., additional, Lapergue, B., additional, Blanc, R., additional, Bourcier, R., additional, Sibon, I., additional, Eugène, F., additional, Vannier, S., additional, Dargazanli, C., additional, Arquizan, C., additional, Anxionnat, R., additional, Richard, S., additional, Fahed, R., additional, Marnat, G., additional, and Gory, B., additional

Published
2022
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15. Safety and Efficacy of Cangrelor in Acute Stroke Treated with Mechanical Thrombectomy: Endovascular Treatment of Ischemic Stroke Registry and Meta-analysis

Author

Marnat, G., primary, Finistis, S., additional, Delvoye, F., additional, Sibon, I., additional, Desilles, J.-P., additional, Mazighi, M., additional, Gariel, F., additional, Consoli, A., additional, Rosso, C., additional, Clarençon, F., additional, Elhorany, M., additional, Denier, C., additional, Chalumeau, V., additional, Caroff, J., additional, Veunac, L., additional, Bourdain, F., additional, Darcourt, J., additional, Olivot, J.-M., additional, Bourcier, R., additional, Dargazanli, C., additional, Arquizan, C., additional, Richard, S., additional, Lapergue, B., additional, and Gory, B., additional

Published
2022
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16. Endovascular therapy with or without intravenous thrombolysis in acute stroke with tandem occlusion

Author

Anadani, M. Marnat, G. Consoli, A. Papanagiotou, P. Nogueira, R.G. Spiotta, A.M. Bourcier, R. Kyheng, M. Labreuche, J. Siddiqui, A.H. Ribo, M. De Havenon, A. Fischer, U. Sibon, I. Dargazanli, C. Arquizan, C. Cognard, C. Olivot, J.M. Anxionnat, R. Audibert, G. Mazighi, M. Blanc, R. Lapergue, B. Richard, S. Gory, B.

Abstract

Background: Endovascular therapy (EVT) is effective and safe in patients with tandem occlusion. The benefit of intravenous thrombolysis (IVT) prior to EVT in acute tandem occlusion is debatable. Objective: To compare EVT alone with EVT plus IVT in patients with acute ischemic stroke due to anterior circulation tandem occlusions. Methods: This is an individual patient pooled analysis of the Thrombectomy In TANdem lesions (TITAN) and Endovascular Treatment in Ischemic Stroke (ETIS) Registries. Patients were divided into two groups based on prior IVT treatment: (1) IVT+ group, which included patients who received IVT prior to EVT, (2) IVT- group, which included patients who did not receive IVT prior to EVT. Propensity score (inverse probability of treatment weighting (IPTW)) was used to reduce baseline between-group differences. The primary outcome was favorable outcome - that is, modified Rankin Scale (mRS) score 0 to 2 at 90 days. Results: Overall, 602 consecutive patients with an acute stroke with tandem occlusion were included (380 and 222 in the bridging therapy and EVT alone groups, respectively). Onset to imaging time was shorter in the IVT+ group (median 103 vs 140 min). In contrast, imaging to puncture time was longer in the IVT+ group (median 107 vs 91 min). In IPTW analysis, the IVT+ group had higher odds of favorable outcome, excellent outcome (90-day mRS score 0-1), and successful reperfusion (modified Thrombolysis in Cerebral Infarction score 2b/3 at the end of EVT). There was no difference in the risk of significant hemorrhagic complications between groups. In secondary analysis of patients treated with acute cervical internal carotid artery stenting, bridging therapy was associated with higher odds of favorable outcome and lower odds of mortality at 90 days. Conclusions: Our results suggest that bridging therapy in patients with acute ischemic stroke due to anterior tandem occlusion is safe and may improve functional outcome, even in the setting of acute cervical internal carotid artery stenting during EVT. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Published
2021

17. First-line thrombectomy strategy for anterior large vessel occlusions: Results of the prospective ETIS egistry

Author

Maïer, B. Finitsis, S. Bourcier, R. Papanagiotou, P. Richard, S. Marnat, G. Sibon, I. Dargazanli, C. Arquizan, C. Blanc, R. Piotin, M. Lapergue, B. Consoli, A. Eugene, F. Vannier, S. Saleme, S. Macian, F. Clarençon, F. Rosso, C. Naggara, O. Turc, G. Viguier, A. Cognard, C. Wolff, V. Pop, R. Mazighi, M. Gory, B.

Abstract

Background: The best recanalization strategy for mechanical thrombectomy (MT) remains unknown as no randomized controlled trial has simultaneously evaluated first-line stent retriever (SR) versus contact aspiration (CA) versus the combined approach (SR+CA). Objective: To compare the efficacy and safety profiles of SR, CA, and SR+CA in patients with acute ischemic stroke (AIS) treated by MT. Methods: We analyzed data of the Endovascular Treatment in Ischemic Stroke (ETIS) Registry, a prospective, multicenter, observational study of patients with AIS treated by MT. Patients with M1 and intracranial internal carotid artery (ICA) occlusions between January 2015 and March 2020 in 15 comprehensive stroke centers were included. We assessed the association of first-line strategy with favorable outcomes at 3 months (modified Rankin Scale score 0-2), successful recanalization rates (modified Thrombolysis In Cerebral Infarction (mTICI) 2b/3), and safety outcomes. Results: We included 2643 patients, 406 treated with SR, 1126 with CA, and 1111 with SR+CA. CA or SR+CA achieved more successful recanalization than SR for M1 occlusions (aOR=2.09, (95% CI 1.39 to 3.13) and aOR=1.69 (95% CI 1.12 to 2.53), respectively). For intracranial ICA, SR+CA achieved more recanalization than SR (aOR=2.52 (95% CI 1.32 to 4.81)), no differences were observed between CA and SR+CA. SR+CA was associated with lower odds of favorable outcomes compared with SR (aOR=0.63 (95% CI 0.44 to 0.90)) and CA (aOR=0.71 (95% CI 0.55 to 0.92)), higher odds of mortality at 3 months (aOR=1.56 (95% CI 1.22 to 2.0)) compared with CA, and higher odds of symptomatic intracranial hemorrhage (aOR=1.59 (95% CI 1.1 to 2.3)) compared with CA. Conclusions: Despite high recanalization rates, our results question the safety of the combined approach, which was associated with disability and mortality. Randomized controlled trials are needed to evaluate the efficacy and safety of these techniques. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Published
2021

18. Global impact of COVID-19 on stroke care

Author

Nogueira, R.G. Abdalkader, M. Qureshi, M.M. Frankel, M.R. Mansour, O.Y. Yamagami, H. Qiu, Z. Farhoudi, M. Siegler, J.E. Yaghi, S. Raz, E. Sakai, N. Ohara, N. Piotin, M. Mechtouff, L. Eker, O. Chalumeau, V. Kleinig, T.J. Pop, R. Liu, J. Winters, H.S. Shang, X. Vasquez, A.R. Blasco, J. Arenillas, J.F. Martinez-Galdamez, M. Brehm, A. Psychogios, M.-N. Lylyk, P. Haussen, D.C. Al-Bayati, A.R. Mohammaden, M.H. Fonseca, L. Luís Silva, M. Montalverne, F. Renieri, L. Mangiafico, S. Fischer, U. Gralla, J. Frei, D. Chugh, C. Mehta, B.P. Nagel, S. Mohlenbruch, M. Ortega-Gutierrez, S. Farooqui, M. Hassan, A.E. Taylor, A. Lapergue, B. Consoli, A. Campbell, B.C.V. Sharma, M. Walker, M. Van Horn, N. Fiehler, J. Nguyen, H.T. Nguyen, Q.T. Watanabe, D. Zhang, H. Le, H.V. Nguyen, V.Q. Shah, R. Devlin, T. Khandelwal, P. Linfante, I. Izzath, W. Lavados, P.M. Olavarría, V.V. Sampaio Silva, G. de Carvalho Sousa, A.V. Kirmani, J. Bendszus, M. Amano, T. Yamamoto, R. Doijiri, R. Tokuda, N. Yamada, T. Terasaki, T. Yazawa, Y. Morris, J.G. Griffin, E. Thornton, J. Lavoie, P. Matouk, C. Hill, M.D. Demchuk, A.M. Killer-Oberpfalzer, M. Nahab, F. Altschul, D. Ramos-Pachón, A. Pérez de la Ossa, N. Kikano, R. Boisseau, W. Walker, G. Cordina, S.M. Puri, A. Luisa Kuhn, A. Gandhi, D. Ramakrishnan, P. Novakovic-White, R. Chebl, A. Kargiotis, O. Czap, A. Zha, A. Masoud, H.E. Lopez, C. Ozretic, D. Al-Mufti, F. Zie, W. Duan, Z. Yuan, Z. Huang, W. Hao, Y. Luo, J. Kalousek, V. Bourcier, R. Guile, R. Hetts, S. Al-Jehani, H.M. AlHazzani, A. Sadeghi-Hokmabadi, E. Teleb, M. Payne, J. Lee, J.S. Hong, J.M. Sohn, S.-I. Hwang, Y.-H. Shin, D.H. Roh, H.G. Edgell, R. Khatri, R. Smith, A. Malik, A. Liebeskind, D. Herial, N. Jabbour, P. Magalhaes, P. Ozdemir, A.O. Aykac, O. Uwatoko, T. Dembo, T. Shimizu, H. Sugiura, Y. Miyashita, F. Fukuda, H. Miyake, K. Shimbo, J. Sugimura, Y. Beer-Furlan, A. Joshi, K. Catanese, L. Abud, D.G. Neto, O.G. Mehrpour, M. Al Hashmi, A. Saqqur, M. Mostafa, A. Fifi, J.T. Hussain, S. John, S. Gupta, R. Sivan-Hoffmann, R. Reznik, A. Sani, A.F. Geyik, S. Akıl, E. Churojana, A. Ghoreishi, A. Saadatnia, M. Sharifipour, E. Ma, A. Faulder, K. Wu, T. Leung, L. Malek, A. Voetsch, B. Wakhloo, A. Rivera, R. Barrientos Iman, D.M. Pikula, A. Lioutas, V.-A. Thomalla, G. Birnbaum, L. Machi, P. Bernava, G. McDermott, M. Kleindorfer, D. Wong, K. Patterson, M.S. Fiorot, J.A., Jr. Huded, V. Mack, W. Tenser, M. Eskey, C. Multani, S. Kelly, M. Janardhan, V. Cornett, O. Singh, V. Murayama, Y. Mokin, M. Yang, P. Zhang, X. Yin, C. Han, H. Peng, Y. Chen, W. Crosa, R. Frudit, M.E. Pandian, J.D. Kulkarni, A. Yagita, Y. Takenobu, Y. Matsumaru, Y. Yamada, S. Kono, R. Kanamaru, T. Yamazaki, H. Sakaguchi, M. Todo, K. Yamamoto, N. Sonoda, K. Yoshida, T. Hashimoto, H. Nakahara, I. Cora, E. Volders, D. Ducroux, C. Shoamanesh, A. Ospel, J. Kaliaev, A. Ahmed, S. Rashid, U. Rebello, L.C. Pereira, V.M. Fahed, R. Chen, M. Sheth, S.A. Palaiodimou, L. Tsivgoulis, G. Chandra, R. Koyfman, F. Leung, T. Khosravani, H. Dharmadhikari, S. Frisullo, G. Calabresi, P. Tsiskaridze, A. Lobjanidze, N. Grigoryan, M. Czlonkowska, A. de Sousa, D.A. Demeestere, J. Liang, C. Sangha, N. Lutsep, H.L. Ayo-Martín, Ó. Cruz-Culebras, A. Tran, A.D. Young, C.Y. Cordonnier, C. Caparros, F. De Lecinana, M.A. Fuentes, B. Yavagal, D. Jovin, T. Spelle, L. Moret, J. Khatri, P. Zaidat, O. Raymond, J. Martins, S. Nguyen, T.

Abstract

Background: The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide. Aims: We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy, stroke, and intracranial hemorrhage hospitalizations over a three-month period at the height of the pandemic (1 March–31 May 2020) compared with two control three-month periods (immediately preceding and one year prior). Methods: Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases at participating centers. Results: The hospitalization volumes for any stroke, intracranial hemorrhage, and mechanical thrombectomy were 26,699, 4002, and 5191 in the three months immediately before versus 21,576, 3540, and 4533 during the first three pandemic months, representing declines of 19.2% (95%CI, −19.7 to −18.7), 11.5% (95%CI, −12.6 to −10.6), and 12.7% (95%CI, −13.6 to −11.8), respectively. The decreases were noted across centers with high, mid, and low COVID-19 hospitalization burden, and also across high, mid, and low volume stroke/mechanical thrombectomy centers. High-volume COVID-19 centers (−20.5%) had greater declines in mechanical thrombectomy volumes than mid- (−10.1%) and low-volume (−8.7%) centers (p < 0.0001). There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions. Conclusion: The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, mechanical thrombectomy procedures, and intracranial hemorrhage admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/mechanical thrombectomy volumes. © 2021 World Stroke Organization.

Published
2021

19. Global impact of COVID-19 on stroke care

Author

Nogueira, RG, Abdalkader, M, Qureshi, MM, Frankel, MR, Mansour, OY, Yamagami, H, Qiu, Z, Farhoudi, M, Siegler, JE, Yaghi, S, Raz, E, Sakai, N, Ohara, N, Piotin, M, Mechtouff, L, Eker, O, Chalumeau, V, Kleinig, TJ, Pop, R, Liu, J, Winters, HS, Shang, X, Rodriguez Vasquez, A, Blasco, J, Arenillas, JF, Martinez-Galdamez, M, Brehm, A, Psychogios, M-N, Lylyk, P, Haussen, DC, Al-Bayati, AR, Mohammaden, MH, Fonseca, L, Luis Silva, M, Montalverne, F, Renieri, L, Mangiafico, S, Fischer, U, Gralla, J, Frei, D, Chugh, C, Mehta, BP, Nagel, S, Mohlenbruch, M, Ortega-Gutierrez, S, Farooqui, M, Hassan, AE, Taylor, A, Lapergue, B, Consoli, A, Campbell, BCV, Sharma, M, Walker, M, Van Horn, N, Fiehler, J, Huy, TN, Nguyen, QT, Watanabe, D, Zhang, H, Le, HV, Nguyen, VQ, Shah, R, Devlin, T, Khandelwal, P, Linfante, I, Izzath, W, Lavados, PM, Olavarria, VV, Silva, GS, de Carvalho Sousa, AV, Kirmani, J, Bendszus, M, Amano, T, Yamamoto, R, Doijiri, R, Tokuda, N, Yamada, T, Terasaki, T, Yazawa, Y, Morris, JG, Griffin, E, Thornton, J, Lavoie, P, Matouk, C, Hill, MD, Demchuk, AM, Killer-Oberpfalzer, M, Nahab, F, Altschul, D, Ramos-Pachon, A, Perez de la Ossa, N, Kikano, R, Boisseau, W, Walker, G, Cordina, SM, Puri, A, Kuhn, AL, Gandhi, D, Ramakrishnan, P, Novakovic-White, R, Chebl, A, Kargiotis, O, Czap, A, Zha, A, Masoud, HE, Lopez, C, Ozretic, D, Al-Mufti, F, Zie, W, Duan, Z, Yuan, Z, Huang, W, Hao, Y, Luo, J, Kalousek, V, Bourcier, R, Guile, R, Hetts, S, Al-Jehani, HM, AlHazzani, A, Sadeghi-Hokmabadi, E, Teleb, M, Payne, J, Lee, JS, Hong, JM, Sohn, S-I, Hwang, Y-H, Shin, DH, Roh, HG, Edgell, R, Khatri, R, Smith, A, Malik, A, Liebeskind, D, Herial, N, Jabbour, P, Magalhaes, P, Ozdemir, AO, Aykac, O, Uwatoko, T, Dembo, T, Shimizu, H, Sugiura, Y, Miyashita, F, Fukuda, H, Miyake, K, Shimbo, J, Sugimura, Y, Beer-Furlan, A, Joshi, K, Catanese, L, Abud, DG, Pontes Neto, O, Mehrpour, M, Al Hashmi, A, Saqqur, M, Mostafa, A, Fifi, JT, Hussain, S, John, S, Gupta, R, Sivan-Hoffmann, R, Reznik, A, Sani, AF, Geyik, S, Akil, ECR, Churojana, A, Ghoreishi, A, Saadatnia, M, Sharifipour, E, Ma, A, Faulder, K, Wu, T, Leung, L, Malek, A, Voetsch, B, Wakhloo, A, Rivera, R, Barrientos Iman, DM, Pikula, A, Lioutas, V-A, Thomalla, G, Birnbaum, L, Machi, P, Bernava, G, McDermott, M, Kleindorfer, D, Wong, K, Patterson, MS, Fiorot, JA, Huded, V, Mack, W, Tenser, M, Eskey, C, Multani, S, Kelly, M, Janardhan, V, Cornett, O, Singh, V, Murayama, Y, Mokin, M, Yang, P, Zhang, X, Yin, C, Han, H, Peng, Y, Chen, W, Crosa, R, Frudit, ME, Pandian, JD, Kulkarni, A, Yagita, Y, Takenobu, Y, Matsumaru, Y, Yamada, S, Kono, R, Kanamaru, T, Yamazaki, H, Sakaguchi, M, Todo, K, Yamamoto, N, Sonoda, K, Yoshida, T, Hashimoto, H, Nakahara, I, Cora, E, Volders, D, Ducroux, C, Shoamanesh, A, Ospel, J, Kaliaev, A, Ahmed, S, Rashid, U, Rebello, LC, Pereira, VM, Fahed, R, Chen, M, Sheth, SA, Palaiodimou, L, Tsivgoulis, G, Chandra, R, Koyfman, F, Leung, T, Khosravani, H, Dharmadhikari, S, Frisullo, G, Calabresi, P, Tsiskaridze, A, Lobjanidze, N, Grigoryan, M, Czlonkowska, A, de Sousa, DA, Demeestere, J, Liang, C, Sangha, N, Lutsep, HL, Ayo-Martin, O, Cruz-Culebras, A, Tran, AD, Young, CY, Cordonnier, C, Caparros, F, Alonso De Lecinana, M, Fuentes, B, Yavagal, D, Jovin, T, Spelle, L, Moret, J, Khatri, P, Zaidat, O, Raymond, J, Martins, S, Thanh, N, Nogueira, RG, Abdalkader, M, Qureshi, MM, Frankel, MR, Mansour, OY, Yamagami, H, Qiu, Z, Farhoudi, M, Siegler, JE, Yaghi, S, Raz, E, Sakai, N, Ohara, N, Piotin, M, Mechtouff, L, Eker, O, Chalumeau, V, Kleinig, TJ, Pop, R, Liu, J, Winters, HS, Shang, X, Rodriguez Vasquez, A, Blasco, J, Arenillas, JF, Martinez-Galdamez, M, Brehm, A, Psychogios, M-N, Lylyk, P, Haussen, DC, Al-Bayati, AR, Mohammaden, MH, Fonseca, L, Luis Silva, M, Montalverne, F, Renieri, L, Mangiafico, S, Fischer, U, Gralla, J, Frei, D, Chugh, C, Mehta, BP, Nagel, S, Mohlenbruch, M, Ortega-Gutierrez, S, Farooqui, M, Hassan, AE, Taylor, A, Lapergue, B, Consoli, A, Campbell, BCV, Sharma, M, Walker, M, Van Horn, N, Fiehler, J, Huy, TN, Nguyen, QT, Watanabe, D, Zhang, H, Le, HV, Nguyen, VQ, Shah, R, Devlin, T, Khandelwal, P, Linfante, I, Izzath, W, Lavados, PM, Olavarria, VV, Silva, GS, de Carvalho Sousa, AV, Kirmani, J, Bendszus, M, Amano, T, Yamamoto, R, Doijiri, R, Tokuda, N, Yamada, T, Terasaki, T, Yazawa, Y, Morris, JG, Griffin, E, Thornton, J, Lavoie, P, Matouk, C, Hill, MD, Demchuk, AM, Killer-Oberpfalzer, M, Nahab, F, Altschul, D, Ramos-Pachon, A, Perez de la Ossa, N, Kikano, R, Boisseau, W, Walker, G, Cordina, SM, Puri, A, Kuhn, AL, Gandhi, D, Ramakrishnan, P, Novakovic-White, R, Chebl, A, Kargiotis, O, Czap, A, Zha, A, Masoud, HE, Lopez, C, Ozretic, D, Al-Mufti, F, Zie, W, Duan, Z, Yuan, Z, Huang, W, Hao, Y, Luo, J, Kalousek, V, Bourcier, R, Guile, R, Hetts, S, Al-Jehani, HM, AlHazzani, A, Sadeghi-Hokmabadi, E, Teleb, M, Payne, J, Lee, JS, Hong, JM, Sohn, S-I, Hwang, Y-H, Shin, DH, Roh, HG, Edgell, R, Khatri, R, Smith, A, Malik, A, Liebeskind, D, Herial, N, Jabbour, P, Magalhaes, P, Ozdemir, AO, Aykac, O, Uwatoko, T, Dembo, T, Shimizu, H, Sugiura, Y, Miyashita, F, Fukuda, H, Miyake, K, Shimbo, J, Sugimura, Y, Beer-Furlan, A, Joshi, K, Catanese, L, Abud, DG, Pontes Neto, O, Mehrpour, M, Al Hashmi, A, Saqqur, M, Mostafa, A, Fifi, JT, Hussain, S, John, S, Gupta, R, Sivan-Hoffmann, R, Reznik, A, Sani, AF, Geyik, S, Akil, ECR, Churojana, A, Ghoreishi, A, Saadatnia, M, Sharifipour, E, Ma, A, Faulder, K, Wu, T, Leung, L, Malek, A, Voetsch, B, Wakhloo, A, Rivera, R, Barrientos Iman, DM, Pikula, A, Lioutas, V-A, Thomalla, G, Birnbaum, L, Machi, P, Bernava, G, McDermott, M, Kleindorfer, D, Wong, K, Patterson, MS, Fiorot, JA, Huded, V, Mack, W, Tenser, M, Eskey, C, Multani, S, Kelly, M, Janardhan, V, Cornett, O, Singh, V, Murayama, Y, Mokin, M, Yang, P, Zhang, X, Yin, C, Han, H, Peng, Y, Chen, W, Crosa, R, Frudit, ME, Pandian, JD, Kulkarni, A, Yagita, Y, Takenobu, Y, Matsumaru, Y, Yamada, S, Kono, R, Kanamaru, T, Yamazaki, H, Sakaguchi, M, Todo, K, Yamamoto, N, Sonoda, K, Yoshida, T, Hashimoto, H, Nakahara, I, Cora, E, Volders, D, Ducroux, C, Shoamanesh, A, Ospel, J, Kaliaev, A, Ahmed, S, Rashid, U, Rebello, LC, Pereira, VM, Fahed, R, Chen, M, Sheth, SA, Palaiodimou, L, Tsivgoulis, G, Chandra, R, Koyfman, F, Leung, T, Khosravani, H, Dharmadhikari, S, Frisullo, G, Calabresi, P, Tsiskaridze, A, Lobjanidze, N, Grigoryan, M, Czlonkowska, A, de Sousa, DA, Demeestere, J, Liang, C, Sangha, N, Lutsep, HL, Ayo-Martin, O, Cruz-Culebras, A, Tran, AD, Young, CY, Cordonnier, C, Caparros, F, Alonso De Lecinana, M, Fuentes, B, Yavagal, D, Jovin, T, Spelle, L, Moret, J, Khatri, P, Zaidat, O, Raymond, J, Martins, S, and Thanh, N

Abstract

BACKGROUND: The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide. AIMS: We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy, stroke, and intracranial hemorrhage hospitalizations over a three-month period at the height of the pandemic (1 March-31 May 2020) compared with two control three-month periods (immediately preceding and one year prior). METHODS: Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases at participating centers. RESULTS: The hospitalization volumes for any stroke, intracranial hemorrhage, and mechanical thrombectomy were 26,699, 4002, and 5191 in the three months immediately before versus 21,576, 3540, and 4533 during the first three pandemic months, representing declines of 19.2% (95%CI, -19.7 to -18.7), 11.5% (95%CI, -12.6 to -10.6), and 12.7% (95%CI, -13.6 to -11.8), respectively. The decreases were noted across centers with high, mid, and low COVID-19 hospitalization burden, and also across high, mid, and low volume stroke/mechanical thrombectomy centers. High-volume COVID-19 centers (-20.5%) had greater declines in mechanical thrombectomy volumes than mid- (-10.1%) and low-volume (-8.7%) centers (p < 0.0001). There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions. CONCLUSION: The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, mechanical thrombectomy procedures, and intracranial hemorrhage admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/mechanical thrombectomy volumes.

Published
2021

20. A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke

Author

Amarenco P, Kim J, Labreuche J, Charles H, Abtan J, Bejot Y, Cabrejo L, Cha J, Ducrocq G, Giroud M, Guidoux C, Hobeanu C, Kim Y, Lapergue B, Lavallee P, Lee B, Lee K, Leys D, Mahagne M, Meseguer E, Nighoghossian N, Pico F, Samson Y, Sibon I, Steg P, Sung S, Touboul P, Touze E, Varenne O, Vicaut E, Yelles N, Bruckert E, Treat Stroke Target Investigators, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Asan Medical Center [Seoul], University of Ulsan, Santé Publique : épidémiologie et qualité des soins (EA 2694), Faculté de Médecine Henri Warembourg - Université de Lille-Centre d'Etudes et de Recherche en Informatique Médicale [Lille] (CERIM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université de Bourgogne (UB), Service de neurologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Catholic University of Korea, Hôpital Foch [Suresnes], Hallym University Sacred Heart Hospital [Anyang, South Korea] (HUS2H), Soonchunhyang University [Asan], CHU Lille, Hôpital Pasteur [Nice] (CHU), Hospices Civils de Lyon (HCL), Centre Hospitalier de Versailles André Mignot (CHV), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Pusan National University Hospital, Physiopathologie et imagerie des troubles neurologiques (PhIND), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), GIP Cyceron (Cyceron), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Cardiologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], 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, Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), Université de Picardie Jules Verne (UPJV), CHU Amiens-Picardie, and Treat Stroke to Target Investigators: Pierre Amarenco, Eric Bruckert, Maurice Giroud, Jong S Kim, Julien Labreuche, Byung-Chul Lee, Marie-Hélène Mahagne, Norbert Nighoghossian, Philippe Gabriel Steg, Pierre-Jean Touboul, Eric Vicaut, Didier Leys, Philippa Lavallée, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, YunJeong In, Elena Meseguer, Philippa C Lavallée, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Chiara Zavanone, Flore Baronnet, Christine Pires, Bertrand Lapergue, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Fernando Pico, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Gurkan Mutlu, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Candice Sabben, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Marion Yger, Yannick Béjot, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-BègueMarsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Frédéric Philippeau, Angel Olaru, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, Emmanuel Touzé, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal-Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani, Mathieu Zuber, Marie Bruandet, Claire Join-Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, Adam Amer Alnajar-Carpentier, Michèle Levasseur, Pierre Louchart, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, Marc Bataillard, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jong Sung Kim, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-Kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Woo-Keun Seo, Jongwon Chung

Subjects
Adult, Male, medicine.medical_specialty, Statin, medicine.drug_class, [SDV]Life Sciences [q-bio], MEDLINE, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Brain Ischemia, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Text mining, Pharmacotherapy, Randomized controlled trial, law, Internal medicine, Humans, Medicine, cardiovascular diseases, 030212 general & internal medicine, Aged, Intention-to-treat analysis, business.industry, Cholesterol, Anticholesteremic Agents, Cholesterol, LDL, General Medicine, Middle Aged, Atherosclerosis, Ezetimibe, Intention to Treat Analysis, Stroke, chemistry, Cardiovascular Diseases, Ischemic Attack, Transient, Ischemic stroke, Drug Therapy, Combination, Female, lipids (amino acids, peptides, and proteins), Hydroxymethylglutaryl-CoA Reductase Inhibitors, business
Abstract

International audience; BACKGROUND: The use of intensive lipid-lowering therapy by means of statin medications is recommended after transient ischemic attack (TIA) and ischemic stroke of atherosclerotic origin. The target level for low-density lipoprotein (LDL) cholesterol to reduce cardiovascular events after stroke has not been well studied. METHODS: In this parallel-group trial conducted in France and South Korea, we randomly assigned patients with ischemic stroke in the previous 3 months or a TIA within the previous 15 days to a target LDL cholesterol level of less than 70 mg per deciliter (1.8 mmol per liter) (lower-target group) or to a target range of 90 mg to 110 mg per deciliter (2.3 to 2.8 mmol per liter) (higher-target group). All the patients had evidence of cerebrovascular or coronary-artery atherosclerosis and received a statin, ezetimibe, or both. The composite primary end point of major cardiovascular events included ischemic stroke, myocardial infarction, new symptoms leading to urgent coronary or carotid revascularization, or death from cardiovascular causes. RESULTS: A total of 2860 patients were enrolled and followed for a median of 3.5 years; 1430 were assigned to each LDL cholesterol target group. The mean LDL cholesterol level at baseline was 135 mg per deciliter (3.5 mmol per liter), and the mean achieved LDL cholesterol level was 65 mg per deciliter (1.7 mmol per liter) in the lower-target group and 96 mg per deciliter (2.5 mmol per liter) in the higher-target group. The trial was stopped for administrative reasons after 277 of an anticipated 385 end-point events had occurred. The composite primary end point occurred in 121 patients (8.5%) in the lower-target group and in 156 (10.9%) in the higher-target group (adjusted hazard ratio, 0.78; 95% confidence interval, 0.61 to 0.98; P = 0.04). The incidence of intracranial hemorrhage and newly diagnosed diabetes did not differ significantly between the two groups. CONCLUSIONS: After an ischemic stroke or TIA with evidence of atherosclerosis, patients who had a target LDL cholesterol level of less than 70 mg per deciliter had a lower risk of subsequent cardiovascular events than those who had a target range of 90 mg to 110 mg per deciliter. (Funded by the French Ministry of Health and others; Treat Stroke to Target ClinicalTrials.gov number, NCT01252875.).

Published
2020

22. HDL and endothelial protection

Author

Tran-Dinh, A, Diallo, D, Delbosc, S, Varela-Perez, Maria L, Dang, Q B, Lapergue, B, Burillo, E, Michel, J B, Levoye, A, Martin-Ventura, J L, and Meilhac, O

Published
2013
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25. Large vessel stroke in six patients following SARS‐CoV‐2 infection: a retrospective case study series of acute thrombotic complications on stable underlying atherosclerotic disease

Author

Lapergue, B., primary, Lyoubi, A., additional, Meseguer, E., additional, Avram, I., additional, Denier, C., additional, Venditti, L., additional, Consoli, A., additional, Guedon, A., additional, Houdart, E., additional, Weisenburger‐Lile, D., additional, Piotin, M., additional, Maier, B., additional, Obadia, M., additional, and Broucker, T.D.E., additional

Published
2020
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28. First-Line Sofia Aspiration Thrombectomy Approach within the Endovascular Treatment of Ischemic Stroke Multicentric Registry: Efficacy, Safety, and Predictive Factors of Success

Author

Marnat, G., primary, Barreau, X., additional, Detraz, L., additional, Bourcier, R., additional, Gory, B., additional, Sgreccia, A., additional, Gariel, F., additional, Berge, J., additional, Menegon, P., additional, Kyheng, M., additional, Labreuche, J., additional, Consoli, A., additional, Blanc, R., additional, and Lapergue, B., additional

Published
2019
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29. Prognosis and risk factors associated with asymptomatic intracranial hemorrhage after endovascular treatment of large vessel occlusion stroke: a prospective multicenter cohort study.

Author

Constant Dit Beaufils, P., Preterre, C., De Gaalon, S., Labreuche, J., Mazighi, M., Di Maria, F., Sibon, I., Marnat, G., Gariel, F., Blanc, R., Gory, B., Consoli, A., Zhu, F., Richard, S., Fahed, R., Desal, H., Lapergue, B., Guillon, B., Bourcier, R., and Piotin, Michel

Subjects
ENDOVASCULAR surgery, STROKE, COHORT analysis, HEMORRHAGE, PROGNOSIS, GROIN pain
Abstract

Background and purpose: Asymptomatic intracranial hemorrhage (aICH) is a common occurrence after endovascular treatment (EVT) for acute ischemic stroke (AIS). The aims of this study were to address its impact on 3‐month functional outcome and to identify risk factors for aICH after EVT. Methods: Patients with AIS attributable to anterior circulation large vessel occlusion who underwent EVT were enrolled in a multicenter prospective registry. Based on imaging performed 22–36 h post‐EVT, we included patients with no intracranial hemorrhage (ICH) or aICH. Poor outcome defined as a 3‐month modified Rankin Scale (mRS) score 4–6 and overall 3‐month mRS score distribution were compared according to presence/absence of aICH, and aICH subtype using logistic regression. We assessed the risk factors of aICH using a multivariate logistic regression model. Results: Of the 1526 patients included in the study, 653 (42.7%) had aICH. Patients with aICH had a higher rate of poor outcome: odds ratio (OR) 1.88 (95% confidence interval [CI] 1.44–2.44). Shift analysis of mRS score found a fully adjusted OR of 1.79 (95% CI 1.47–2.18). Hemorrhagic infarction (OR 1.63 [95% CI 1.22–2.18]) and parenchymal hematoma (OR 2.99 [95% CI 1.77–5.02]) were associated with higher risk of poor outcome. Male sex, diabetes, coronary artery disease, baseline National Institutes of Health Stroke Scale score and Alberta Stroke Program Early Computed Tomography Score, number of passes and onset to groin puncture time were independently associated with aICH. Conclusions: Patients with aICH, irrespective of the radiological pattern, have a worse functional outcome at 3 months compared with those without ICH after EVT for AIS. The number of EVT passes and the time from onset to groin puncture are factors that could be modified to reduce deleterious ICH. [ABSTRACT FROM AUTHOR]

Published
2021
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30. Predictive factors of functional independence after optimal reperfusion in anterior circulation ischaemic stroke with indication for intravenous thrombolysis plus mechanical thrombectomy.

Author

Riou‐Comte, N., Guillemin, F., Gory, B., Lapergue, B., Zhu, F., Soudant, M., Piotin, M., Humbertjean, L., Mione, G., Lacour, J.‐C., Anxionnat, R., Hossu, G., Bracard, S., and Richard, S.

Subjects
BASILAR artery, THROMBECTOMY, REPERFUSION, THROMBOLYTIC therapy, STROKE, MODEL validation
Abstract

Background and purpose: Intravenous thrombolysis plus mechanical thrombectomy (IVT + MT) is the best current management of acute stroke due to large‐vessel occlusion and results in optimal reperfusion for most patients. Nevertheless, some of these patients do not subsequently achieve functional independence. The aim was to identify baseline factors associated with 3‐month independence after optimal reperfusion and to validate a prediction model. Methods: All consecutive patients with intracranial anterior large‐vessel occlusion, with indication for IVT + MT and achieving optimal reperfusion (defined as modified Treatment in Cerebral Ischaemia score 2b–3), from the THRACE trial and the ETIS registry, were included in order to identify a prediction model. The primary outcome was 3‐month independence [modified Rankin Scale (mRS) score ≤ 2]. Multivariate inferences invoked forward logistic regression, multiple imputation and bootstrap resampling. Predictive performance was assessed by c‐statistic. Model validation was conducted on patients from the ASTER trial. Results: Amongst 139 patients (mean age 65.5 years; 54.3% female), predictors of 3‐month mRS ≤ 2 (n = 82) were younger age [odds ratio 0.62 per 10‐year increase; 95% confidence interval (CI) 0.53–0.72] and higher Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (odds ratio 1.65 per 1‐point increase; 95% CI 1.47–1.86) with c‐statistic 0.77. Model validation (n = 104/181 patients with 3‐month mRS ≤ 2) demonstrated a moderate discrimination (c‐statistic 0.74; 95% CI 0.66–0.81) combining age and ASPECTS. The validation model was improved by the adjunction of three candidate variables that were found to be predictors. Addition of baseline National Institutes of Health Stroke Scale (NIHSS) score, history of vascular risk factor and onset‐to‐reperfusion time significantly improved discrimination (c‐statistic 0.85; 95% CI 0.83–0.87). Conclusions: After optimal reperfusion, younger age, higher ASPECTS, lower NIHSS score, shorter onset‐to‐reperfusion time and absence of vascular risk factor were predictive of independence and could help to guide patient management. [ABSTRACT FROM AUTHOR]

Published
2021
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31. Neurological improvement predicts clinical outcome after acute basilar artery stroke thrombectomy.

Author

Guenego, A., Bourcier, R., Guillen, M., Weisenburger‐Lile, D., Lapergue, B., Gory, B., Richard, S., Ducroux, C., Piotin, M., Blanc, R., Labreuche, J., Lucas, L., Detraz, L., Aubertin, M., Dargazanli, C., Benali, A., Vannier, S., Eugene, F., Lun, R., and Walker, G.

Subjects
BASILAR artery, THROMBECTOMY, FORECASTING, STROKE patients, STROKE
Abstract

Background and purpose: Mechanical thrombectomy (MT) is the standard of care for patients with anterior circulation large vessel occlusion. Early neurological improvement (ENI), defined as a reduction of ≥ 8 on the National Institutes of Health Stroke Scale (NIHSS) compared with baseline score, or an NIHSS score of 0 or 1 at 24 h after MT, is a strong predictor of 3‐month favorable outcome in such patients. The impact of ENI after MT in stroke patients with basilar artery occlusion (BAO) on 3‐month outcome is not clear. We aimed to study the effects of ENI in patients with BAO. Methods: We performed a retrospective analysis of a multicenter prospective cohort of all consecutive stroke patients with BAO who underwent MT. We compared clinical outcomes between BAO patient groups according to ENI status. Multivariate analyses were performed to determine the impact of ENI on favorable 90‐day outcome (modified Rankin scale score 0–3) and to report factors contributing to ENI. Results: A total of 237 patients were included. ENI was observed in 70 patients (30%). Outcomes were significantly better in ENI‐positive patients, with 84% achieving favorable outcome (mRS score 0–3) at 3 months versus 30% for ENI‐negative patients (P < 0.0001). In multivariate analysis, ENI was an independent predictive factor associated with higher rates of favorable outcome {odds ratio (OR) 18.12 [95% confidence interval (CI) 3.95–83.10]; P = 0.0001}. Higher number of passes [OR 0.62 (95% CI 0.43–0.89); P = 0.010] and need for stenting [OR 0.27 (95% CI 0.07–0.95); P = 0.041] were negatively associated with ENI. Conclusion: Early neurological improvement on day 1 following MT for BAO is a strong independent predictor of a favorable 3‐month clinical outcome. [ABSTRACT FROM AUTHOR]

Published
2021
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33. Supplementary Material for: Is Reperfusion Useful in Ischaemic Stroke Patients Presenting with a Low National Institutes of Health Stroke Scale and a Proximal Large Vessel Occlusion of the Anterior Circulation?

Author

Dargazanli, C., Consoli, A., Gory, B., Blanc, R., Labreuche, J., Preda, C., Bourdain, F., Decroix, J.-P., Redjem, H., Ciccio, G., Mazighi, M., Smajda, S., Desilles, J.-P., Riva, R., Labeyrie, P.-E., Coskun, O., Rodesch, G., Turjman, F., Piotin, M., and Lapergue, B.

Abstract

Background: In population-based studies, patients presenting with minor or mild stroke symptoms represent about two-thirds of stroke patients, and almost one-third of these patients are unable to ambulate independently at the time of discharge. Although mechanical thrombectomy (MT) has become the standard of care for acute ischaemic stroke with proximal large vessel occlusion (LVO) in the anterior circulation, the management of patients harbouring proximal occlusion and minor-to-mild stroke symptoms has not yet been determined by recent trials. The purpose of this study was to evaluate the impact of reperfusion on clinical outcome in low National Institutes of Health Stroke Scale (NIHSS) patients treated with MT. Methods: We analysed 138 consecutive patients with acute LVO of the anterior circulation (middle cerebral artery M1 or M2 segment, internal carotid artery or tandem occlusion) with NIHSS Results: Successful reperfusion was achieved in 81.2% of patients (TICI 2B, n = 47; TICI 3, n = 65). Excellent outcome (mRs 0-1) was achieved in 69 patients (65.0%) and favourable outcome (mRs ≤2) in 108 (78.3%). Death occurred in 7 (5.1%). Excellent outcome increased with reperfusion grades, with a rate of 34.6% in patients with failed/poor reperfusion, 61.7% in patients with TICI 2B reperfusion, and 78.5% in patients with TICI 3 reperfusion (p < 0.001). In multivariate analysis adjusted for patient characteristics associated with excellent outcome, the reperfusion grade remained significantly associated with an increase in excellent outcome; the OR (95% CI) was 3.09 (1.06-9.03) for TICI 2B and 6.66 (2.27-19.48) for TICI 3, using the failed/poor reperfusion grade as reference. Similar results were found regarding favourable outcome (90-day mRs 0-2) or overall mRS distribution (shift analysis). Conclusion: Successful reperfusion is strongly associated with better functional outcome among patients with proximal LVO in the anterior circulation and minor-to-mild stroke symptoms. Randomized controlled studies are mandatory to assess the benefit of MT compared with optimal medical management in this subset of patients.

Published
2017
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35. Two‐layered susceptibility vessel sign is associated with biochemically quantified thrombus red blood cell content.

Author

Di Meglio, L., Derraz, I., Solonomenjanahary, M., Daly, D., Chodraui Filho, S., Ben Maacha, M., Labreuche, J., Desal, H., Consoli, A., Lapergue, B., Blanc, R., Piotin, M., Mazighi, M., Ho‐Tin‐Noé, B., Desilles, J. P., Bourcier, R., Redjem, Hocine, Smajda, Stanislas, Ciccio, Gabriele, and Fahed, Robert

Subjects
ERYTHROCYTES, ENDOVASCULAR surgery, ENZYME-linked immunosorbent assay, RADIOLOGIC technology, MAGNETIC resonance imaging, THROMBOSIS
Abstract

Background and purpose: Better characterization of the thrombus could be useful to determine acute ischaemic stroke (AIS) aetiology and predict response to thrombolysis and endovascular therapy (EVT). To test the hypothesis that susceptibility vessel sign (SVS) on baseline magnetic resonance imaging (MRI) is related to red blood cell (RBC) content of AIS thrombi, the total haemoglobin contents (HbCs) of AIS thrombi retrieved by EVT from patients with or without SVS or two‐layered SVS (TLSVS) were compared. Methods: Baseline MRI of 84 anterior AIS patients was reviewed by neuro‐radiologists blinded to clinical and biochemical data. Thrombi from these patients were retrieved by EVT and analysed for HbC by quantitative enzyme‐linked immunosorbent assay and measurement of haem concentration. Results: Susceptibility vessel sign and TLSVS were respectively observed in 85.7% and 50.0% of cases. The median HbC content was 253 µg/mg thrombus (interquartile range 177–333) and the median haem content was 219 µg/mg thrombus (131–264). Thrombus HbC and haem content were highly correlated with thrombus RBC content determined by flow cytometry (r = 0.94). Thrombi from patients with TLSVS weighed more [31.1 (16.5–68.3) mg vs. 17.7 (11.7–33.3) mg; P = 0.005] and had a higher HbC content [278 (221–331) µg/mg vs. 196 (139–301) µg/mg; P = 0.010] compared to thrombi from patients without TLSVS. There was no difference in thrombus weight or HbC content according to SVS status. Conclusions: Our study shows that TLSVS is significantly associated with a higher thrombus weight and RBC content, as determined by quantitative assays. [ABSTRACT FROM AUTHOR]

Published
2020
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39. French Intensive Care Society, International congress - Réanimation 2016

Author

Jaillette, E, Girault, C, Brunin, G, Zerimech, F, Chiche, A, Broucqsault Dedrie, C, Fayolle, C, Minacori, F, Alves, I, Barrailler, S, Robriquet, L, Delaporte, E, Thellier, D, Delcourte, C, Duhamel, A, Nseir, S, Valette, X, Desmeulles, I, Savary, B, Masson, R, Seguin, A, Daubin, C, Sauneuf, B, Verrier, P, Pottier, V, Orabona, M, Samba, D, Viquesnel, G, Lermuzeaux, M, Hazera, P, Hanouz, J, Parienti, J, Du Cheyron, D, Demoule, A, Clavel, M, Rolland Debord, C, Perbet, S, Terzi, N, Kouatchet, A, Wallet, F, Roze, H, Vargas, F, Guérin, C, Dellamonica, J, Jaber, S, Similowski, T, Quenot, J, Binquet, C, Vinsonneau, C, Barbar, S, Vinault, S, Deckert, V, Lemaire, S, Hssain, A, Bruyère, R, Souweine, B, Lagrost, L, Adrie, C, Jung, B, Daurat, A, De Jong, A, Chanques, G, Mahul, M, Monnin, M, Molinari, N, Lheureux, O, Trepo, E, Hites, M, Cotton, F, Wolff, F, Surin, R, Créteur, J, Vincent, J, Gustot, T, Jacobs, F, Taccone, F, Neuville, M, Timsit, J, El Helali, N, Le Monnier, A, Magalhaes, E, Radjou, A, Smonig, R, Soubirou, J, Voiriot, G, Sonneville, R, Bouadma, L, Mourvillier, B, Gélisse, E, Brasseur, A, Roisin, S, De Backer, D, Van Ruychevelt, V, Carlier, E, Piagnerelli, M, Vanhaeverbeek, M, Danguy, C, Biston, P, Au, S, Begot, E, Dalmay, F, Repessé, X, Prat, G, Bouferrache, K, Slama, M, Vieillard Baron, A, Monnet, X, Marik, P, Teboul, J, Jozwiak, M, Richard, C, Chauvet, J, El Dash, S, Delastre, O, Bouffandeau, B, Jusserand, D, Michot, J, Bauer, F, Brazier, F, Mercado, P, Kontar, L, Titeca, D, De Cagny, B, Bacari Risal, G, Riviere, A, Maizel, J, Guillot, C, Le Reun, C, Lampin, M, Sadik, A, Botte, A, Leteurtre, S, Collins, A, Kempeneers, C, Cajgfinger, N, Ohlmann, C, Pouyau, R, Subtil, F, Baudin, F, Massenavette, B, Javouhey, E, Milesi, C, Essouri, S, Liet, J, Afanetti, M, Durand, S, Durand, P, Roze, J, Dupont, D, Cambonie, G, Soyer, B, Rusca, M, Lukaszewicz, A, Crassard, I, Guichard, J, Bresson, D, de la Garanderie, D, Cantier, M, Sabben, C, Louedec, L, Delbosc, S, Journé, C, Ou, P, Klein, I, Chau, F, Lefort, A, Desilles, J, Michel, J, Mazighi, M, Salem, O, Demeret, S, Bolgert, F, Sharshar, T, Grabli, D, Arib, S, Crippa, I, Soummer, A, Engrand, N, Guedin, P, Aldea, S, Cerf, C, Desailly, V, Pasquier, P, Brun, P, Roux, D, Latournerie, G, Kasprzyk, L, Grosjean, V, Latreche, A, Habert, P, Huot, S, Jobin, T, Tesnière, A, Dreyfuss, D, Ricard, J, Mignon, A, Gaudry, S, Laithier, F, Kimmoun, A, Chouihed, T, Albizzati, S, Camenzind, E, Vanhuyse, F, Levy, B, Cour, M, Venet, F, Hernu, R, Demaret, J, Monneret, G, Argaud, L, Dumas, F, Lamhaut, L, Rosencher, J, Pène, F, Varenne, O, Carli, P, Jouven, X, Spaulding, C, Cariou, A, Geri, G, Bonnetain, F, Marijon, E, Empana, J, Mirouse, A, Resche Rigon, M, Mayaux, J, Rabbat, A, Meert, A, Benoit, D, Bruneel, F, Azoulay, E, Dupuis, C, Schwebel, C, Ruckly, S, Goldgran Toledano, D, Marcotte, G, Lafarge, A, Pichereau, C, Theodose, I, Scotto, M, Kemlin, D, Ghrenassia, E, Schlemmer, B, Vimpere, D, Galicier, L, Contou, D, Guérot, E, Grimaldi, D, Ricome, S, Maury, E, Plantefève, G, Dessap, A, Brun Buisson, C, de Prost, N, Dubé, B, Delemazure, J, Dres, M, Rousseau, L, Drouot, X, Diaz, V, Rebollar, Y, Frat, J, Thille, A, Aissa, D, Coquet, P, Ruiz, J, Ferre, F, Hoarau, L, Riu Poulenc, B, Bataille, B, Silva, S, Baudel, J, Bigé, N, Tahiri, J, Dubée, V, Guidet, B, Ait Oufella, H, Jinglun, L, Shen, F, Bailly, S, Leroy, O, Montravers, P, Constantin, J, Dupont, H, Guillemot, D, Lortholary, O, Perrigault, P, Gangneux, J, Razazi, K, Mekontso Dessap, A, Jansen, C, Lecronier, M, Sandrine, V, Mira, J, Blein, S, Marin, N, Rousseau, C, Charpentier, J, Pachot, A, Hraiech, S, Bordes, J, De, L, Mège, J, Forel, J, Guervilly, C, Adda, M, Raoult, D, Papazian, L, Kentish Barnes, N, Cohen Solal, Z, Souppart, V, Kerhuel, L, Haubertin, C, Exbrayat, I, Rozières, E, Argain, A, Suc, A, Vignes, M, Cougot, P, Fourcade, O, Brunel, E, Messika, J, Tubach, F, Dubief, E, Pasquet, B, Guillo, S, Pierron, C, Grimaud, M, Farnoux, C, Maillard, A, Decavèle, M, Prodanovic, H, Idbaih, A, Alentorn, A, Delattre, J, De Montmollin, E, Brule, N, Conrad, M, Dailler, F, Navellou, J, Alves, M, Tonnelier, J, Picard, G, Rogemond, V, Honnorat, J, Marzorati, C, Lebert, C, Perez, P, Citerio, G, Legriel, S, Tripon, S, Mallet, M, Rudler, M, Imbert Bismut, F, Thabut, D, Canet, E, Faguer, S, Moreau, A, Barbier, F, Merceron, S, Guitton, C, Labadie, F, Lemiale, V, Faucher, E, Klouche, K, Chevret, S, Ragot, S, Coudroy, R, Boulain, T, Jamet, A, Mercat, A, Brochard, L, Roux, A, Franchineau, G, Brechot, N, Lebreton, G, Hekimian, G, Nieszkowska, A, Leprince, P, Trouillet, J, Combes, A, Schmidt, M, Barrot, L, Piton, G, Bailey, M, Panwar, R, Belin, N, Belon, F, Patry, C, Grandperrin, M, Chaignat, C, Labro, G, Vivet, B, Capellier, G, Daix, T, Guérin, E, Tavernier, E, Mercier, E, Gissot, V, Vallejo, C, François, B, Ravry, C, Pichon, N, Chapellas, C, Fedou, A, Galy, A, Ploy, M, Barraud, O, Vignon, P, Thooft, A, Conotte, R, Colet, J, Le Dorze, M, Tarazona, V, Brumpt, C, Moins Teisserenc, H, Uhel, F, Azzaoui, I, Gregoire, M, Pangault, C, Dulong, J, Cynober, L, Roussel, M, Le Tulzo, Y, Tarte, K, Demiselle, J, Auchabie, J, Dequin, P, Chudeau, N, Fourrier, F, Grange, S, Piquilloud, L, Lautrette, A, Boyer, S, Letheulle, J, Lerolle, N, Truche, A, Clec'H, C, Zaoui, P, Laurent, V, Toledano, D, Ragey, S, Gros, A, Dumenil, A, Jamali, S, Darmon, M, Chouraqui, M, Dewitte, A, Chastel, B, Carles, P, Fleureau, C, Joannes Boyau, O, Ouattara, A, Joseph, A, Garrouste Orgeas, M, Max, A, Lerin, T, Grégoire, C, Kloeckner, M, Bruel, C, Brochon, S, Philippart, F, Pichot, E, Simons, C, Flint, A, Aubron, C, Bellomo, R, Pilcher, D, Cheng, A, Hegarty, C, Martinelli, A, Howden, B, Reade, M, Mcquilten, Z, Bretonnière, C, Villers, D, Soares, M, Gonzalez, F, Vincent, F, Fauché, C, Gay, S, Skowron, O, Levrat, A, Dorez, D, Foucrier, A, Pease, S, Gauss, T, Paugam, C, Gorham, J, Ameye, L, Paesmans, M, Berghmans, T, Sculier, J, Deras, P, Martinez, O, Latry, P, Capdevila, X, Charbit, J, Jaubert, J, Etiennar, C, Ginoux, L, Sebbah, J, Haouache, H, Dhonneur, G, Cheikh, C, Moussaid, I, Ghazaoui, O, Belkadi, K, El Youssoufi, S, Salmi, S, Pajot, L, Zuber, B, Bedos, J, Dupont, B, Eugène, A, Galateau Sallé, F, Michard, B, Lebas, B, Boivin, A, Guillot, M, Harlay, M, Janssen Langenstein, R, Schenck, M, Ellero, B, Woehl Jaegle, M, Besch, C, Castelain, V, Bachellier, P, Schneider, F, Camus, C, Saliba, F, Goubaux, B, Bonadona, A, Lavayssiere, L, Quinart, A, Barbot, O, Dharancy, S, Delafosse, B, Barraud, H, Galbois, A, Veber, B, Cayot, S, Souche, B, Locher, C, Roux, O, Figorilli, F, Putignano, A, Houssel, P, Francoz, C, Weiss, E, Agarwal, B, Jalan, R, Durand, F, Ghezala, H, Daoudi, R, Kaddour, M, Ghadhoune, H, Rachedi, E, Guissouma, J, Ben Slimene, A, Azzeza, W, Brahmi, H, Elghord, H, Kada, A, Chikh, R, Slimani, R, A. Bouyoucef, K, Regaieg, K, Kamilia, C, Baccouche, N, Turki, O, Chaari, A, Ben, H, Bouaziz, M, Medhioub, F, Zekri, M, Rgieg, K, Bhimada, C, Mounir, B, Lang, E, Welschbillig, S, Perrin, M, Devys, J, Benbernou, S, Mokhtari Djebli, H, Ilies, S, Bouyacoub, K, Azza, A, Zogheib, E, Nader, J, Villeret, L, Guilbart, M, Besserve, P, Caus, T, Mastroianni, C, Santi, F, Hékimian, G, Pascal, L, Chastre, J, Perrier, V, Deniau, B, Klasen, F, Ponthus, J, Ngasseu, P, Amilien, V, Barsam, E, Lehericey, P, Tchir, M, Georger, J, Puech, B, Vandroux, D, Roussiaux, A, Belcour, D, Ferdynus, C, Martinet, O, Jabot, J, Fresco, M, Demeilliers Pfister, G, Merle, V, Brunel, V, Dureuil, B, Leydier, S, Clerc Urmes, I, Lemarie, J, Maigrat, C, Cravoisy Popovic, A, Barraud, D, Nace, L, Gibot, S, Agrinier, N, Bollaert, P, Daban, J, Boutonnet, M, Dumas, G, Falzone, E, Jault, P, Lenoir, B, Makunza, J, Mejeni, N, Mazaud, A, Béague, S, Rousselle, A, Durocher, A, Grinea, A, Bedoui, N, Stoian, A, Baboi, L, Gobert, F, Yonis, H, Tapponier, R, Bruyneel, A, Bonus, T, Cuvelier, G, Machayeckhi, S, Olieuz, S, Legrand, A, Feki, F, Jamoussi, A, Merhebene, T, Braham, E, Ghariani, A, Mezni, F, Slim, L, Khelil, J, Besbes, M, Marchalot, A, Beduneau, G, Carpentier, D, Besnier, E, Gastaldi, G, Abily, J, Beuzelin, M, Nay, M, Mankikian, J, Hervé, V, Soulie, M, Cronier, P, Kantor, E, Federici, L, Gilbert, M, Mezhari, I, Choukroun, G, Marque, S, Coppere, Z, Fulgencio, J, Blayau, C, Pham, T, Djibre, M, Reffienna, M, Lefort, S, Debue, A, Daviaud, F, Cabon, S, Addou, Z, Douah, A, Moussati, M, Belhabiche, K, Aouffen, N, Soulier, S, Mauriat, P, Tafer, N, Mortamet, G, Amaddeo, A, Khirani, S, Fauroux, B, Khanes, G, Liutko, O, Bidnenko, S, Doye, E, Voirin, N, Maucort Boulch, D, Kolev Descamp, K, Aouane, I, Essid, A, Hammami, W, Haegy, I, Bataille, J, Bergounioux, J, Morin, L, Ray, S, Maclaren, G, Nadel, S, Kneyber, M, Peters, M, Jansen, K, De Luca, D, Wilson, C, Schlapbach, L, Tissières, P, Girard, A, Savajols, E, Burguet, A, Semama, D, Litzler Renault, S, Fredj, H, Hassouna, M, Hechmi, Y, Cherif, M, Zouheir, J, Dernane, A, Bouakkaz, F, Taleb, L, Zeddine Mouhsen, A, Lyazidi, A, Richard, J, Mouhsen, A, Harmouchi, M, Rattal, M, Huck, M, Leclerc, T, Donat, N, Cirodde, A, Schaal, J, Masson, Y, Hoffmann, C, Cerland, L, Valentino, R, Chabartier, C, Villain Coquet, L, Ferge, J, Brouste, Y, Mehdaoui, H, Louriz, M, Madani, N, Amlaiky, F, Dendane, T, Abidi, K, Zekraoui, A, Zeggwagh, A, Abouqal, R, Brahim, A, Ferhi, F, Bouslama, M, Benjazia, K, Zeineb, A, Mahassen, D, Cadiet, J, Ferron, M, Prat, V, Erraud, A, Aillerie, V, Mevel, M, Grabherr, A, Chatham, J, Gauthier, C, Lauzier, B, Rozec, B, Joffre, J, Loyer, X, Lavillegrand, J, Zeboudj, L, Laurans, L, Esposito, B, Tedgui, A, Mallat, Z, Wei, C, Kattani, N, Louis, H, Orlowski, S, Tharaux, P, Burban, M, Meyer, G, Olland, A, Yver, B, Toti, F, Schini Kerth, V, Monnier, A, Leborgne, P, Meziani, F, Clavier, T, Paulus, M, Castel, H, Richard, V, Pons, S, Skurnik, D, Six, S, Jaffal, K, Vigneron, C, Large, A, Bador, J, Aho, S, Prin, S, Touil, Y, Ayed, S, Ali, H, Tilouch, N, Mateur, H, Talik, I, Gharbi, R, Hassen, M, Elatrous, S, Patry, I, Bertrand, X, Zahar, J, Essaied, W, Wolkewitz, M, Soued, M, Cook, F, Lobo, D, Mounier, R, Emirian, A, Decousser, J, Slaoui, M, Benslama, A, Valance, D, Allou, N, Allyn, J, Jean Bart, E, Bel, F, Morey, F, Sedillot, N, Biard, L, Galliot, R, Zunarelli, R, Gauzere, B, Cartier, J, Jouve, T, Hilleret, M, Hamidfar Roy, R, Ara Somohano, C, Minet, C, Pourcelet, A, Hougardy, J, Defrance, P, De Laforcade, L, Boyer, A, Gruson, D, Clouzeau, B, Hajjam, N, Nasri, H, Doghri, H, Mongardon, N, Levesque, E, Bastide, M, Richecoeur, J, Frenoy, E, Lemaire, C, Schortgen, F, Preau, S, Ehooman, F, Montlahuc, C, Bardon, J, Postel Vinay, N, Lafi, M, Prat, D, Le Meur, M, Moneger, G, Demars, N, Trouiller, P, Tencé, N, Zaien, I, Wolf, M, Allardet Servent, J, Lebsir, M, Dubroca, C, Portugal, M, Castanier, M, Signouret, T, Soundaravelou, R, Lepidi, A, Halfon, P, Seghboyan, J, Gamblin, C, Benturquia, N, Roussel, O, Chevillard, L, Risede, P, Callebert, J, Khelfa, M, Blel, Y, Thabet, H, Brahmi, N, Amamou, M, Le Louët, A, Baud, F, Le Beller, C, Vivien, B, Soufir, L, Le Louët, H, Essafi, F, Foudhaili, N, Slimen, A, Jabla, R, Hammed, H, Marzouk, M, Boujelbene, N, Dachraoui, F, Hachani, A, Abdallah, S, Lakhal, H, Ghribi, C, Ali, I, Abdellaoui, I, Ouanes Besbes, L, Abroug, F, Demiri, S, Lorut, C, Van Lang, D, Lefebvre, A, Alifano, M, Reignard, J, Samama, M, Dusser, D, Roche, N, Réminiac, F, Landel, C, Gensburger, S, Bocar, T, Mordier, L, Philippe, M, Le Pennec, D, Vecellio, L, Ehrmann, S, Poiroux, L, Thevoz, D, Simons, J, Roeseler, J, Loiez, A, Gérard, S, Dousse, N, L'Hotellier, S, Baumgarten, E, Borschneck, S, Kharcha, F, Ghander, C, Tresallet, C, Puymirat, E, Fagon, J, Aegerter, P, Diehl, J, Hauw Berlemont, C, Chatellier, G, Danchin, N, Aissaoui, N, Aissat, N, Bernard, R, Amour, J, Bouglé, A, Vidal, C, Nima, D, Shaida, V, Dorget, A, Bréchot, N, Toufiki, R, Mouaffak, Y, Adib, A, Amine, M, Moumine, S, Jonard, M, Ducloy Bouthors, A, Bouju, P, Barbarot, N, Gacouin, A, Fillatre, P, Grillet, G, Goepp, A, Clairet, A, Limat, S, Cornette, C, Fatnassi, A, Romdhani, C, Sammoud, W, Labbene, I, Ferjani, M, Taibi, H, Elatiqi, I, Iraqui, A, Cherkab, R, Haddad, W, Elkettani, C, Barrou, L, Cave, F, Doutrellot, P, Vaysse, B, Inan, M, Khelfoun, K, Nasserallah, M, Legrand Monteil, C, Tasseel Ponche, S, Kowalski, B, Guaguere, A, Boulle Geronimi, C, Masse, J, Vanbaelinghem, C, Herbecq, P, Mokline, A, Draief, S, Gharsallah, L, Rahmani, I, Gasri, B, Tlaili, S, Hammouda, R, Messadi, A, Michel, P, Gelée, B, Fadel, F, Thuong, M, Ait Aoudia, S, Laddi, S, Sahraoui, M, Muller, M, Faucher, A, Hermann, B, Berlemont, C, Arnaout, M, Busson, J, Dhumeaux, J, Ericher, N, Lucas, P, Dumas, M, Chapelle, C, Philippon Jouve, B, Morel, J, Beuret, P, Bureau, C, Poitou, T, Petua, P, Prades, A, Basty, M, Monet, C, Mounet, B, Futier, E, Leroux, A, Oudinot, X, Laurent, M, Ouanes, I, Jochmans, S, Alphonsine, J, Van Vong, L, Rolin, N, Sy, O, Serbource Goguel, J, Ellrodt, O, Monchi, M, Bahloul, M, Olfa, T, Chokri, B, Chelly, H, Trichot, A, Colin, G, Vinatier, I, Bachoumas, K, Lacherade, J, Fiancette, M, Joret, A, Yehia, A, Henry Laguarrigue, M, Martin Lefèvre, L, Surenaud, M, Bedet, A, Seemann, A, Hüe, S, Clere Jehl, R, Charles, A, Geny, B, Bilbault, P, Bourcier, S, Lejour, G, Boêlle, P, Safaa, N, Paulus, S, Flamens, C, Neidecker, J, Rambaud, J, Allioux, C, Guedj, R, Guellec, I, Guilbert, J, Leger, P, Demoulin, M, Durandy, A, Jean, S, Carbajal, R, Morand, A, Zieleskiewicz, L, Brissaud, O, Le Bel, S, Meresse, Z, Panuel, M, Thomachot, L, Leone, M, Michel, F, Deho', A, Sadozai, L, Dauger, S, Prot Labarthe, S, Genuini, M, Florence, M, Treluyer, J, Renolleau, S, Chalavon, E, Dessein, R, Grandbastien, B, Pesin, S, Dubos, F, Puel, M, Szulc, M, Philippe, A, Severac, F, Astruc, D, Kuhn, P, Desprez, P, Aoul, N, Colomb, B, Petion, A, Queudet, L, Remy, S, Youssef, M, Roumeliotis, N, Dong, C, Pettersen, G, Crevier, L, Emeriaud, G, Naudin, J, Abdallah, L, Ganier, M, Frannais, K, Douglas, D, Flusin, C, Brossier, D, Eltaani, R, Sauthier, M, Guillois, B, Larroquet, M, Amblard, A, Lode, N, Casadevall, I, Kessous, K, Walti, H, Poiré, C, Chen, H, Megarbane, B, M'Rad, A, Habacha, S, Chatbri, B, Masniere, C, Souissi, S, Ghord, H, Kouraichi, N, Marhbène, T, Mejri, I, Lakhdar, D, Merhabane, T, la Maamouri, H, Charlotte, O, Wegelius, H, Landelle, C, Schrenzel, J, Kaiser, L, Pugin, J, Belhadj, H, Chanareille, P, Ladureau, A, Sanna, A, Rolle, A, Pons, B, Piednoir, P, Ardisson, F, Martino, F, Bernos, T, Elkoun, K, Elain, E, Lawson, R, Resh Rigon, M, Belorgey, S, Thiery, G, Pricopi, C, Barthes, F, Doddie, T, Nsiala, M, Situakibanza, N, Amisi, B, Kazadi, M, Kilembe, M, Clement, C, Lamontagne, F, Boyer, V, Naimo, S, Raulais, R, Genevois, E, Bouchoud, L, Boroli, F, Abidi, N, Abbas, M, Harbarth, S, Charles, P, Dereux, C, De Guillebon, S, Morisse, E, France, J, Gasser, 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C, Rooze, S, Moullet, C, Henin, A, Ettori, F, Zemmour, C, Boher, J, Feltry, A, Ben, S, Audibert, J, Conia, A, Gontier, O, Hamrouni, M, Lherm, T, Ouchenir, A, Rétif, J, Proudhom, A, Lagardere, C, Tissot, S, Kalfon, P, Sacre, L, Villa, A, Khadija, A, Garnier, R, Vasset, B, Heinzelman, A, Jouffroy, R, Durand, E, Compagnon, P, Jebri, A, Legout, C, Castot Villepelet, A, Valade, S, Lesieur, O, Delmas, B, Visseaux, B, Cohen, J, Nguyen, L, Morbieu, C, Burdet, C, Lescure, F, Armand Lefevre, L, Yazdanpanah, Y, Houhou Fidouh, N, Cazaux, M, Goff Jérôme, L, Meignin, V, Boutboul, D, Rispail, P, Besnard, N, Ceballos, P, Stoclin, A, Rotolo, F, Wartelle, M, Hicheri, Y, Maillet, S, Chachaty, E, Pignon, J, Bialais, E, Julie, D, Paoloni, L, Wittebolle, X, Hickmann, C, Castanares Zapatero, D, Tordeur, A, Colmant, L, Wittebole, X, Tirone, G, Laterre, P, Ducroux, L, Kemlin, C, Moulton, E, Rosso, C, Le Neindre, A, Mongodi, S, Bouhemad, B, Rodrigues, J, Botteau, C, Waroquier, F, Christiaens, K, Vantrimpont, F, Elkhawand, C, Vermeesh, F, Vermeesh, F., and CITERIO, GIUSEPPE

Abstract

Determinants of outcome in critically ill patients with hematological malignancy and central neurological failure: data from the TRIAL OH study

Published
2016

40. Impact of Modified TICI 3 versus Modified TICI 2b Reperfusion Score to Predict Good Outcome following Endovascular Therapy

Author

Dargazanli, C., primary, Consoli, A., additional, Barral, M., additional, Labreuche, J., additional, Redjem, H., additional, Ciccio, G., additional, Smajda, S., additional, Desilles, J.P., additional, Taylor, G., additional, Preda, C., additional, Coskun, O., additional, Rodesch, G., additional, Piotin, M., additional, Blanc, R., additional, and Lapergue, B., additional

Published
2016
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41. O-001 Impact of Recanalization in Patients with Pretreatment DWI-ASPECTS ≤6 Treated with Endovascular Therapy

Author

Desilles, J, primary, Consoli, A, additional, Escalard, S, additional, Redjem, H, additional, Blanc, R, additional, Guedin, P, additional, Coskun, O, additional, Ciccio, G, additional, Smajda, S, additional, Ruiz Guerrero, C, additional, Sasannejad, P, additional, Rodesch, G, additional, Piotin, M, additional, and Lapergue, B, additional

Published
2016
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42. A Direct Aspiration, First Pass Technique (ADAPT) versus Stent Retrievers for Acute Stroke Therapy: An Observational Comparative Study

Author

Lapergue, B., primary, Blanc, R., additional, Guedin, P., additional, Decroix, J.-P., additional, Labreuche, J., additional, Preda, C., additional, Bartolini, B., additional, Coskun, O., additional, Redjem, H., additional, Mazighi, M., additional, Bourdain, F., additional, Rodesch, G., additional, and Piotin, M., additional

Published
2016
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43. Impact of thrombolysis in acute ischaemic stroke without occlusion: an observational comparative study

Author

Ajili, N., primary, Decroix, J. P., additional, Preda, C., additional, Labreuche, J., additional, Lopez, D., additional, Bejot, Y., additional, Michel, P., additional, Sévin‐Allouet, M., additional, Sibon, I., additional, Vergnet, S., additional, Wang, A., additional, Sanda, N., additional, Mazighi, M., additional, Bourdain, F., additional, and Lapergue, B., additional

Published
2016
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44. Impact of intravenous thrombolysis and emergent carotid stenting on reperfusion and clinical outcomes in patients with acute stroke with tandem lesion treated with thrombectomy: a collaborative pooled analysis.

Author

the Thrombectomy In TANdem lesions (TITAN) investigators, Gory, B., Lapergue, B., Dorn, F., Cognard, C., Killer, M., Mangiafico, S., Ribo, M., Psychogios, M. N., Spiotta, A. M., Labeyrie, M. A., Biondi, A., Haussen, D. C., Nogueira, R. G., Turjman, F., Piotin, M., Mazighi, M., Steglich‐Arnholm, H., Holtmannspötter, M., and Labreuche, J.

Subjects
THROMBOLYTIC therapy, REPERFUSION injury, ARTERIAL dissections, CEREBRAL infarction, STROKE, SURGICAL stents, HEALTH outcome assessment, TISSUE wounds
Abstract

Background and purpose: Tandem anterior circulation lesions in the setting of acute ischemic stroke (AIS) are a complex endovascular situation that has not been specifically addressed in trials. We determined the predictors of successful reperfusion and good clinical outcome at 90 days after mechanical thrombectomy (MT) in patients with AIS with tandem lesions in a pooled collaborative study. Methods: This was a retrospective analysis of consecutive patients presenting to 18 comprehensive stroke centers with AIS due to tandem lesion of the anterior circulation who underwent MT. Results: A total of 395 patients were included. Successful reperfusion (modified thrombolysis in cerebral infarction score 2b–3) was achieved in 76.7%. At 90 days, 52.2% achieved a good outcome (modified Rankin Scale score 0–2), 13.8% suffered a parenchymal hematoma and 13.2% were dead. Lower National Institutes of Health Stroke Scale score [odds ratio (OR), 1.26; 95% confidence intervals (CI), 1.07–1.48, P = 0.004], Alberta Stroke Program Early CT Score ≥7 (OR, 2.00; 95% CI, 1.07–3.43, P = 0.011), intravenous thrombolysis (OR, 1.47; 95% CI, 1.01–2.12, P = 0.042) and stenting of the extracranial carotid lesion (OR, 1.63; 95% CI, 1.04–2;53, P = 0.030) were independently associated with successful reperfusion. Lower age (OR, 1.58; 95% CI, 1.26–1.97, P < 0.001), absence of hypercholesterolemia (OR, 1.77; 95% CI, 1.10–2.84, P = 0.018), lower National Institutes of Health Stroke Scale scores (OR, 2.04; 95% CI, 1.53–2.72, P < 0.001), Alberta Stroke Program Early CT Score ≥7 (OR, 2.75; 95% CI, 1.24–6.10, P = 0.013) and proximal middle cerebral artery occlusion (OR, 1.59; 95% CI, 1.03–2.44, P = 0.035) independently predicted a good 90‐day outcome. Conclusions: Intravenous thrombolysis and emergent stenting of the extracranial carotid lesion were predictors of a successful reperfusion after MT of patients with AIS with tandem lesion of the anterior circulation. [ABSTRACT FROM AUTHOR]

Published
2018
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45. Unknown‐onset strokes with anterior circulation occlusion treated by thrombectomy after DWI‐FLAIR mismatch selection.

Author

Escalard, S., Gory, B., Kyheng, M., Desilles, J.‐P., Redjem, H., Ciccio, G., Smajda, S., Labreuche, J., Mazighi, M., Piotin, M., Blanc, R., Lapergue, B., Fahed, R., and of the ETIS (Endovascular Treatment in Ischemic Stroke) Research Investigators

Subjects
STROKE, COHORT analysis, DIABETES, HYPERTENSION, THROMBOLYTIC therapy
Abstract

Background and purpose: The DAWN trial recently showed compelling evidence in treating late window and wake‐up stroke patients with thrombectomy using a clinical‐imaging mismatch. The aim was to evaluate the results of thrombectomy for unknown‐onset strokes (UOS) treated in our centres after a diffusion weighted imaging/fluid attenuated inversion recovery (DWI‐FLAIR) mismatch based selection. Methods: A multicentre, cohort study was performed of consecutive UOS treated by thrombectomy between 2012 and 2016. UOS with proximal anterior circulation occlusion discovered beyond 6 h from ‘last seen normal’ were compared with known‐onset strokes (KOS) for whom thrombectomy was started within 6 h from onset. Time intervals were recorded from first time found abnormal. Results were adjusted for age, diabetes, hypertension, National Institutes of Health Stroke Scale, site of occlusion, DWI Alberta Stroke Programme Early CT Score, intravenous thrombolysis and use of general anaesthesia. Results: Amongst 1246 strokes with anterior circulation occlusion treated by thrombectomy, 277 were UOS, with a ‘last time seen well’ beyond 6 h and DWI‐FLAIR mismatch, and 865 were KOS who underwent groin puncture within 6 h. Favourable outcome was achieved less often in UOS than KOS patients (45.2% vs. 53.9%, P = 0.022). After pre‐specified adjustment, this difference was not significant (adjusted relative risk 0.91; 95% confidence interval 0.80–1.04; P = 0.17). No differences were found in secondary outcomes. Time intervals from first found abnormal were significantly longer in UOS. Conclusion: Thrombectomy of UOS with anterior circulation occlusion and DWI‐FLAIR mismatch appears to be as safe and efficient as thrombectomy of KOS within 6 h from onset. This pattern of imaging could be used for patient selection when time of onset is unknown. [ABSTRACT FROM AUTHOR]

Published
2018
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49. Blood-brain barrier disruption is associated with increased mortality after endovascular therapy

Author

Desilles, J.-P., primary, Rouchaud, A., additional, Labreuche, J., additional, Meseguer, E., additional, Laissy, J.-P., additional, Serfaty, J.-M., additional, Lapergue, B., additional, Klein, I. F., additional, Guidoux, C., additional, Cabrejo, L., additional, Sirimarco, G., additional, Lavallee, P. C., additional, Schouman-Claeys, E., additional, Amarenco, P., additional, and Mazighi, M., additional

Published
2013
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