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1. Cerebral microbleeds and risk of symptomatic hemorrhagic transformation following mechanical thrombectomy for large vessel ischemic stroke

Author

Agbonon, Rémi, Forestier, Géraud, Bricout, Nicolas, Benhassen, Wagih, Turc, Guillaume, Bretzner, Martin, Pasi, Marco, benzakoun, Joseph, Seners, Pierre, Derraz, Imad, Legrand, Laurence, Trystram, Denis, Rodriguez-Regent, Christine, Charidimou, Andreas, Rost, Natalia S., Bracard, Serge, Cordonnier, Charlotte, Eker, Omer F., Oppenheim, Catherine, Naggara, Olivier, Henon, Hilde, and Boulouis, Grégoire

Published
2024
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3. Small vessel disease and collaterals in ischemic stroke patients treated with thrombectomy

Author

Forestier, Géraud, Agbonon, Rémi, Bricout, Nicolas, Benhassen, Wagih, Turc, Guillaume, Bretzner, Martin, Pasi, Marco, Benzakoun, Joseph, Seners, Pierre, Personnic, Thomas, Legrand, Laurence, Trystram, Denis, Rodriguez-Regent, Christine, Charidimou, Andreas, Rost, Natalia S., Bracard, Serge, Clarençon, Frédéric, Eker, Omer F., Nighoghossian, Norbert, Cordonnier, Charlotte, Oppenheim, Catherine, Naggara, Olivier, Henon, Hilde, and Boulouis, Grégoire

Published
2022
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8. Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19

Author

Marto, J, Strambo, D, Ntaios, G, Nguyen, T, Herzig, R, Czlonkowska, A, Demeestere, J, Mansour, O, Salerno, A, Wegener, S, Baumgartner, P, Cereda, C, Bianco, G, Beyeler, M, Arnold, M, Carrera, E, Machi, P, Altersberger, V, Bonati, L, Gensicke, H, Bolognese, M, Peters, N, Wetzel, S, Magrico, M, Ramos, J, Sargento-Freitas, J, Machado, R, Maia, C, Machado, E, Nunes, A, Ferreira, P, Pinho E Melo, T, Dias, M, Paula, A, Correia, M, Castro, P, Azevedo, E, Albuquerque, L, Alves, J, Ferreira-Pinto, J, Meira, T, Pereira, L, Rodrigues, M, Araujo, A, Rocha, M, Pereira-Fonseca, A, Ribeiro, L, Varela, R, Malheiro, S, Cappellari, M, Zivelonghi, C, Sajeva, G, Zini, A, Gentile, M, Forlivesi, S, Migliaccio, L, Sessa, M, La Gioia, S, Pezzini, A, Sangalli, D, Zedde, M, Pascarella, R, Ferrarese, C, Beretta, S, Diamanti, S, Schwarz, G, Frisullo, G, Marcheselli, S, Seners, P, Sabben, C, Escalard, S, Piotin, M, Maier, B, Charbonnier, G, Vuillier, F, Legris, L, Cuisenier, P, Vodret, F, Marnat, G, Liegey, J, Sibon, I, Flottmann, F, Broocks, G, Gloyer, N, Bohmann, F, Schaefer, J, Nolte, C, Audebert, H, Siebert, E, Sykora, M, Lang, W, Ferrari, J, Mayer-Suess, L, Knoflach, M, Gizewski, E, Stolp, J, Stolze, L, Coutinho, J, Nederkoorn, P, Van Den Wijngaard, I, De Meris, J, Lemmens, R, De Raedt, S, Vandervorst, F, Rutgers, M, Guilmot, A, Dusart, A, Bellante, F, Calleja-Castano, P, Ostos, F, Gonzalez-Ortega, G, Martin-Jimenez, P, Garcia-Madrona, S, Cruz-Culebras, A, Vera, R, Matute, M, Fuentes, B, Alonso-De-Lecinana, M, Rigual, R, Diez-Tejedor, E, Perez-Sanchez, S, Montaner, J, Diaz-Otero, F, Perez-De-La-Ossa, N, Flores-Pina, B, Munoz-Narbona, L, Chamorro, A, Rodriguez-Vazquez, A, Renu, A, Ayo-Martin, O, Hernandez-Fernandez, F, Segura, T, Tejada-Meza, H, Sagarra-Mur, D, Serrano-Ponz, M, Hlaing, T, See, I, Simister, R, Werring, D, Kristoffersen, E, Nordanstig, A, Jood, K, Rentzos, A, Simunek, L, Krajickova, D, Krajina, A, Mikulik, R, Cvikova, M, Vinklarek, J, Skoloudik, D, Roubec, M, Hurtikova, E, Hruby, R, Ostry, S, Skoda, O, Pernicka, M, Jurak, L, Eichlova, Z, Jira, M, Kovar, M, Pansky, M, Mencl, P, Palouskova, H, Tomek, A, Jansky, P, Olserova, A, Sramek, M, Havlicek, R, Maly, P, Trakal, L, Fiksa, J, Slovak, M, Karlinski, M, Nowak, M, Sienkiewicz-Jarosz, H, Bochynska, A, Wrona, P, Homa, T, Sawczynska, K, Slowik, A, Wlodarczyk, E, Wiacek, M, Tomaszewska-Lampart, I, Sieczkowski, B, Bartosik-Psujek, H, Bilik, M, Bandzarewicz, A, Dorobek, M, Zielinska-Turek, J, Nowakowska-Kotas, M, Obara, K, Urbanowski, P, Budrewicz, S, Guzinski, M, Switonska, M, Rutkowska, I, Sobieszak-Skura, P, Labuz-Roszak, B, Debiec, A, Staszewski, J, Stepien, A, Zwiernik, J, Wasilewski, G, Tiu, C, Terecoasa, E, Radu, R, Negrila, A, Dorobat, B, Panea, C, Tiu, V, Petrescu, S, Ozdemir, A, Mahmoud, M, El-Samahy, H, Abdelkhalek, H, Al-Hashel, J, Ismail, I, Salmeen, A, Ghoreishi, A, Sabetay, S, Gross, H, Klein, P, Abdalkader, M, Jabbour, P, El Naamani, K, Tjoumakaris, S, Abbas, R, Mohamed, G, Chebl, A, Min, J, Hovingh, M, Tsai, J, Khan, M, Nalleballe, K, Onteddu, S, Masoud, H, Michael, M, Kaur, N, Maali, L, Abraham, M, Khandelwal, P, Bach, I, Ong, M, Babici, D, Khawaja, A, Hakemi, M, Rajamani, K, Cano-Nigenda, V, Arauz, A, Amaya, P, Llanos, N, Arango, A, Vences, M, Barrientos Guerra, J, Caetano, R, Martins, R, Scollo, S, Yalung, P, Nagendra, S, Gaikwad, A, Seo, K, Georgiopoulos, G, Nogueira, R, Michel, P, Marto J. P., Strambo D., Ntaios G., Nguyen T. N., Herzig R., Czlonkowska A., Demeestere J., Mansour O. Y., Salerno A., Wegener S., Baumgartner P., Cereda C. W., Bianco G., Beyeler M., Arnold M., Carrera E., Machi P., Altersberger V., Bonati L., Gensicke H., Bolognese M., Peters N., Wetzel S., Magrico M., Ramos J. N., Sargento-Freitas J., Machado R., Maia C., Machado E., Nunes A. P., Ferreira P., Pinho E Melo T., Dias M. C., Paula A., Correia M. A., Castro P., Azevedo E., Albuquerque L., Alves J. N., Ferreira-Pinto J., Meira T., Pereira L., Rodrigues M., Araujo A. P., Rocha M., Pereira-Fonseca A., Ribeiro L., Varela R., Malheiro S., Cappellari M., Zivelonghi C., Sajeva G., Zini A., Gentile M., Forlivesi S., Migliaccio L., Sessa M., La Gioia S., Pezzini A., Sangalli D., Zedde M., Pascarella R., Ferrarese C., Beretta S., Diamanti S., Schwarz G., Frisullo G., Marcheselli S., Seners P., Sabben C., Escalard S., Piotin M., Maier B., Charbonnier G., Vuillier F., Legris L., Cuisenier P., Vodret F. R., Marnat G., Liegey J. -S., Sibon I., Flottmann F., Broocks G., Gloyer N. -O., Bohmann F. O., Schaefer J. H., Nolte C., Audebert H. J., Siebert E., Sykora M., Lang W., Ferrari J., Mayer-Suess L., Knoflach M., Gizewski E. R., Stolp J., Stolze L. J., Coutinho J. M., Nederkoorn P., Van Den Wijngaard I., De Meris J., Lemmens R., De Raedt S., Vandervorst F., Rutgers M. P., Guilmot A., Dusart A., Bellante F., Calleja-Castano P., Ostos F., Gonzalez-Ortega G., Martin-Jimenez P., Garcia-Madrona S., Cruz-Culebras A., Vera R., Matute M. C., Fuentes B., Alonso-De-Lecinana M., Rigual R., Diez-Tejedor E., Perez-Sanchez S., Montaner J., Diaz-Otero F., Perez-De-La-Ossa N., Flores-Pina B., Munoz-Narbona L., Chamorro A., Rodriguez-Vazquez A., Renu A., Ayo-Martin O., Hernandez-Fernandez F., Segura T., Tejada-Meza H., Sagarra-Mur D., Serrano-Ponz M., Hlaing T., See I., Simister R., Werring D., Kristoffersen E. S., Nordanstig A., Jood K., Rentzos A., Simunek L., Krajickova D., Krajina A., Mikulik R., Cvikova M., Vinklarek J., Skoloudik D., Roubec M., Hurtikova E., Hruby R., Ostry S., Skoda O., Pernicka M., Jurak L., Eichlova Z., Jira M., Kovar M., Pansky M., Mencl P., Palouskova H., Tomek A., Jansky P., Olserova A., Sramek M., Havlicek R., Maly P., Trakal L., Fiksa J., Slovak M., Karlinski M. A., Nowak M., Sienkiewicz-Jarosz H., Bochynska A., Wrona P., Homa T., Sawczynska K., Slowik A., Wlodarczyk E., Wiacek M., Tomaszewska-Lampart I., Sieczkowski B., Bartosik-Psujek H., Bilik M., Bandzarewicz A., Dorobek M., Zielinska-Turek J., Nowakowska-Kotas M., Obara K., Urbanowski P., Budrewicz S., Guzinski M., Switonska M., Rutkowska I., Sobieszak-Skura P., Labuz-Roszak B. M., Debiec A., Staszewski J., Stepien A., Zwiernik J., Wasilewski G., Tiu C., Terecoasa E. O., Radu R. A., Negrila A., Dorobat B., Panea C., Tiu V., Petrescu S., Ozdemir A., Mahmoud M., El-Samahy H., Abdelkhalek H., Al-Hashel J., Ismail I. I., Salmeen A., Ghoreishi A., Sabetay S. I., Gross H., Klein P., Abdalkader M., Jabbour P., El Naamani K., Tjoumakaris S., Abbas R., Mohamed G. A., Chebl A., Min J., Hovingh M., Tsai J. P., Khan M., Nalleballe K., Onteddu S., Masoud H., Michael M., Kaur N., Maali L., Abraham M. G., Khandelwal P., Bach I., Ong M., Babici D., Khawaja A. M., Hakemi M., Rajamani K., Cano-Nigenda V., Arauz A., Amaya P., Llanos N., Arango A., Vences M. A., Barrientos Guerra J. D., Caetano R., Martins R. T., Scollo S. D., Yalung P. M., Nagendra S., Gaikwad A., Seo K. -D., Georgiopoulos G., Nogueira R. G., Michel P., Marto, J, Strambo, D, Ntaios, G, Nguyen, T, Herzig, R, Czlonkowska, A, Demeestere, J, Mansour, O, Salerno, A, Wegener, S, Baumgartner, P, Cereda, C, Bianco, G, Beyeler, M, Arnold, M, Carrera, E, Machi, P, Altersberger, V, Bonati, L, Gensicke, H, Bolognese, M, Peters, N, Wetzel, S, Magrico, M, Ramos, J, Sargento-Freitas, J, Machado, R, Maia, C, Machado, E, Nunes, A, Ferreira, P, Pinho E Melo, T, Dias, M, Paula, A, Correia, M, Castro, P, Azevedo, E, Albuquerque, L, Alves, J, Ferreira-Pinto, J, Meira, T, Pereira, L, Rodrigues, M, Araujo, A, Rocha, M, Pereira-Fonseca, A, Ribeiro, L, Varela, R, Malheiro, S, Cappellari, M, Zivelonghi, C, Sajeva, G, Zini, A, Gentile, M, Forlivesi, S, Migliaccio, L, Sessa, M, La Gioia, S, Pezzini, A, Sangalli, D, Zedde, M, Pascarella, R, Ferrarese, C, Beretta, S, Diamanti, S, Schwarz, G, Frisullo, G, Marcheselli, S, Seners, P, Sabben, C, Escalard, S, Piotin, M, Maier, B, Charbonnier, G, Vuillier, F, Legris, L, Cuisenier, P, Vodret, F, Marnat, G, Liegey, J, Sibon, I, Flottmann, F, Broocks, G, Gloyer, N, Bohmann, F, Schaefer, J, Nolte, C, Audebert, H, Siebert, E, Sykora, M, Lang, W, Ferrari, J, Mayer-Suess, L, Knoflach, M, Gizewski, E, Stolp, J, Stolze, L, Coutinho, J, Nederkoorn, P, Van Den Wijngaard, I, De Meris, J, Lemmens, R, De Raedt, S, Vandervorst, F, Rutgers, M, Guilmot, A, Dusart, A, Bellante, F, Calleja-Castano, P, Ostos, F, Gonzalez-Ortega, G, Martin-Jimenez, P, Garcia-Madrona, S, Cruz-Culebras, A, Vera, R, Matute, M, Fuentes, B, Alonso-De-Lecinana, M, Rigual, R, Diez-Tejedor, E, Perez-Sanchez, S, Montaner, J, Diaz-Otero, F, Perez-De-La-Ossa, N, Flores-Pina, B, Munoz-Narbona, L, Chamorro, A, Rodriguez-Vazquez, A, Renu, A, Ayo-Martin, O, Hernandez-Fernandez, F, Segura, T, Tejada-Meza, H, Sagarra-Mur, D, Serrano-Ponz, M, Hlaing, T, See, I, Simister, R, Werring, D, Kristoffersen, E, Nordanstig, A, Jood, K, Rentzos, A, Simunek, L, Krajickova, D, Krajina, A, Mikulik, R, Cvikova, M, Vinklarek, J, Skoloudik, D, Roubec, M, Hurtikova, E, Hruby, R, Ostry, S, Skoda, O, Pernicka, M, Jurak, L, Eichlova, Z, Jira, M, Kovar, M, Pansky, M, Mencl, P, Palouskova, H, Tomek, A, Jansky, P, Olserova, A, Sramek, M, Havlicek, R, Maly, P, Trakal, L, Fiksa, J, Slovak, M, Karlinski, M, Nowak, M, Sienkiewicz-Jarosz, H, Bochynska, A, Wrona, P, Homa, T, Sawczynska, K, Slowik, A, Wlodarczyk, E, Wiacek, M, Tomaszewska-Lampart, I, Sieczkowski, B, Bartosik-Psujek, H, Bilik, M, Bandzarewicz, A, Dorobek, M, Zielinska-Turek, J, Nowakowska-Kotas, M, Obara, K, Urbanowski, P, Budrewicz, S, Guzinski, M, Switonska, M, Rutkowska, I, Sobieszak-Skura, P, Labuz-Roszak, B, Debiec, A, Staszewski, J, Stepien, A, Zwiernik, J, Wasilewski, G, Tiu, C, Terecoasa, E, Radu, R, Negrila, A, Dorobat, B, Panea, C, Tiu, V, Petrescu, S, Ozdemir, A, Mahmoud, M, El-Samahy, H, Abdelkhalek, H, Al-Hashel, J, Ismail, I, Salmeen, A, Ghoreishi, A, Sabetay, S, Gross, H, Klein, P, Abdalkader, M, Jabbour, P, El Naamani, K, Tjoumakaris, S, Abbas, R, Mohamed, G, Chebl, A, Min, J, Hovingh, M, Tsai, J, Khan, M, Nalleballe, K, Onteddu, S, Masoud, H, Michael, M, Kaur, N, Maali, L, Abraham, M, Khandelwal, P, Bach, I, Ong, M, Babici, D, Khawaja, A, Hakemi, M, Rajamani, K, Cano-Nigenda, V, Arauz, A, Amaya, P, Llanos, N, Arango, A, Vences, M, Barrientos Guerra, J, Caetano, R, Martins, R, Scollo, S, Yalung, P, Nagendra, S, Gaikwad, A, Seo, K, Georgiopoulos, G, Nogueira, R, Michel, P, Marto J. P., Strambo D., Ntaios G., Nguyen T. N., Herzig R., Czlonkowska A., Demeestere J., Mansour O. Y., Salerno A., Wegener S., Baumgartner P., Cereda C. W., Bianco G., Beyeler M., Arnold M., Carrera E., Machi P., Altersberger V., Bonati L., Gensicke H., Bolognese M., Peters N., Wetzel S., Magrico M., Ramos J. N., Sargento-Freitas J., Machado R., Maia C., Machado E., Nunes A. P., Ferreira P., Pinho E Melo T., Dias M. C., Paula A., Correia M. A., Castro P., Azevedo E., Albuquerque L., Alves J. N., Ferreira-Pinto J., Meira T., Pereira L., Rodrigues M., Araujo A. P., Rocha M., Pereira-Fonseca A., Ribeiro L., Varela R., Malheiro S., Cappellari M., Zivelonghi C., Sajeva G., Zini A., Gentile M., Forlivesi S., Migliaccio L., Sessa M., La Gioia S., Pezzini A., Sangalli D., Zedde M., Pascarella R., Ferrarese C., Beretta S., Diamanti S., Schwarz G., Frisullo G., Marcheselli S., Seners P., Sabben C., Escalard S., Piotin M., Maier B., Charbonnier G., Vuillier F., Legris L., Cuisenier P., Vodret F. R., Marnat G., Liegey J. -S., Sibon I., Flottmann F., Broocks G., Gloyer N. -O., Bohmann F. O., Schaefer J. H., Nolte C., Audebert H. J., Siebert E., Sykora M., Lang W., Ferrari J., Mayer-Suess L., Knoflach M., Gizewski E. R., Stolp J., Stolze L. J., Coutinho J. M., Nederkoorn P., Van Den Wijngaard I., De Meris J., Lemmens R., De Raedt S., Vandervorst F., Rutgers M. P., Guilmot A., Dusart A., Bellante F., Calleja-Castano P., Ostos F., Gonzalez-Ortega G., Martin-Jimenez P., Garcia-Madrona S., Cruz-Culebras A., Vera R., Matute M. C., Fuentes B., Alonso-De-Lecinana M., Rigual R., Diez-Tejedor E., Perez-Sanchez S., Montaner J., Diaz-Otero F., Perez-De-La-Ossa N., Flores-Pina B., Munoz-Narbona L., Chamorro A., Rodriguez-Vazquez A., Renu A., Ayo-Martin O., Hernandez-Fernandez F., Segura T., Tejada-Meza H., Sagarra-Mur D., Serrano-Ponz M., Hlaing T., See I., Simister R., Werring D., Kristoffersen E. S., Nordanstig A., Jood K., Rentzos A., Simunek L., Krajickova D., Krajina A., Mikulik R., Cvikova M., Vinklarek J., Skoloudik D., Roubec M., Hurtikova E., Hruby R., Ostry S., Skoda O., Pernicka M., Jurak L., Eichlova Z., Jira M., Kovar M., Pansky M., Mencl P., Palouskova H., Tomek A., Jansky P., Olserova A., Sramek M., Havlicek R., Maly P., Trakal L., Fiksa J., Slovak M., Karlinski M. A., Nowak M., Sienkiewicz-Jarosz H., Bochynska A., Wrona P., Homa T., Sawczynska K., Slowik A., Wlodarczyk E., Wiacek M., Tomaszewska-Lampart I., Sieczkowski B., Bartosik-Psujek H., Bilik M., Bandzarewicz A., Dorobek M., Zielinska-Turek J., Nowakowska-Kotas M., Obara K., Urbanowski P., Budrewicz S., Guzinski M., Switonska M., Rutkowska I., Sobieszak-Skura P., Labuz-Roszak B. M., Debiec A., Staszewski J., Stepien A., Zwiernik J., Wasilewski G., Tiu C., Terecoasa E. O., Radu R. A., Negrila A., Dorobat B., Panea C., Tiu V., Petrescu S., Ozdemir A., Mahmoud M., El-Samahy H., Abdelkhalek H., Al-Hashel J., Ismail I. I., Salmeen A., Ghoreishi A., Sabetay S. I., Gross H., Klein P., Abdalkader M., Jabbour P., El Naamani K., Tjoumakaris S., Abbas R., Mohamed G. A., Chebl A., Min J., Hovingh M., Tsai J. P., Khan M., Nalleballe K., Onteddu S., Masoud H., Michael M., Kaur N., Maali L., Abraham M. G., Khandelwal P., Bach I., Ong M., Babici D., Khawaja A. M., Hakemi M., Rajamani K., Cano-Nigenda V., Arauz A., Amaya P., Llanos N., Arango A., Vences M. A., Barrientos Guerra J. D., Caetano R., Martins R. T., Scollo S. D., Yalung P. M., Nagendra S., Gaikwad A., Seo K. -D., Georgiopoulos G., Nogueira R. G., and Michel P.

Abstract

Background and Objectives COVID-19–related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19. Methods This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection. With a doubly robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT). Results Of a total of 15,128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19; of those, 5,848 (38.7%) patients received IVT-only and 9,280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted OR 1.53; 95% CI 1.16–2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20–2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23–1.99), 24-hour mortality (OR 2.47; 95% CI 1.58–3.86), and 3-month mortality (OR 1.88; 95% CI 1.52–2.33). Patients with COVID-19 also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26–1.60). Discussion Patients with AIS and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non–COVID-19 patients receiving treatment. Current available data do not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in patients with COVID-19 or to establish different treatment r

Published
2023

10. Recanalization before Thrombectomy in Tenecteplase vs. Alteplase-Treated Drip-and-Ship Patients

Author

Pierre Seners, Jildaz Caroff, Nicolas Chausson, Guillaume Turc, Christian Denier, Michel Piotin, Manvel Aghasaryan, Cosmin Alecu, Olivier Chassin, Bertrand Lapergue, Olivier Naggara, Marc Ferrigno, Caroline Arquizan, Tae-Hee Cho, Ana-Paula Narata, Sébastien Richard, Nicolas Bricout, Mikaël Mazighi, Vincent Costalat, Benjamin Gory, Séverine Debiais, Arturo Consoli, Serge Bracard, Catherine Oppenheim, Jean-Louis Mas, Didier Smadja, Laurent Spelle, and Jean-Claude Baron

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2019
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11. Intravenous thrombolysis with tenecteplase versus alteplase combined with endovascular treatment of anterior circulation tandem occlusions: A pooled analysis of ETIS and TETRIS

Author

Marnat, Gaultier, Lapergue, Bertrand, Gory, Benjamin, Kyheng, Maeva, Labreuche, Julien, Turc, Guillaume, Olindo, Stephanze, Sibon, Igor, Caroff, Jildaz, Smadja, Didier, Chausson, Nicolas, Clarençon, Frederic, Seners, Pierre, Bourcier, Romain, Pop, Raoul, Olivot, Jean-Marc, Mazighi, Mikael, Moulin, Solène, Janot, Kevin, Cognard, Christophe, Alamowitch, Sonia, and Gerschenfeld, Gaspard

Abstract

Background: Tandem occlusions are a singular large vessel occlusion entity involving specific endovascular and perioperative antithrombotic management. In this context, data on safety and efficacy of prior intravenous thrombolysis (IVT) with tenecteplase is scarce. We aimed to compare IVT with tenecteplase or alteplase in patients with acute tandem occlusions intended for endovascular treatment.Patients and methods: A retrospective pooled analysis of two large observational registries (ETIS (Endovascular Treatment of Ischemic Stroke) and TETRIS (Tenecteplase Treatment in Ischemic Stroke)) was performed on consecutive patients presenting with anterior circulation tandem occlusion treated with IVT using either alteplase (ETIS) or tenecteplase (TETRIS) followed by endovascular treatment between January 2015 and June 2022. Sensitivity analyses on atherosclerosis related tandem occlusions and on patient treated with emergent carotid stenting were conducted. Propensity score overlap weighting analyses were performed.Results: We analyzed 753 patients: 124 in the tenecteplase and 629 in the alteplase group. The overall odds of favorable outcome (3-month modified Rankin score 0–2) were comparable between both groups (49.4% vs 47.1%; OR = 1.10, 95%CI 0.85–1.41). Early recanalization, final successful recanalization and mortality favored the use of tenecteplase. The occurrence of any intracranial hemorrhage (ICH) was more frequent after tenecteplase use (OR = 2.24; 95%CI 1.75–2.86). However, risks of symptomatic ICH and parenchymal hematoma remained similar. In atherosclerotic tandems, favorable outcome, mortality, parenchymal hematoma, early recanalization, and final successful recanalization favored the tenecteplase group. In the carotid stenting subgroup, PH were less frequent in the tenecteplase group (OR = 0.18; 95%CI 0.05–0.69).Conclusion: In patients with tandem occlusions, IVT with tenecteplase seemed reasonably safe in particular with increased early recanalization rates. These findings remain preliminary and should be further confirmed in randomized trials.

Published
2024
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13. Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes

Author

Strambo, Davide, Marto, João Pedro, Ntaios, George, Nguyen, Thanh N., Michel, Patrik, Herzig, Roman, Członkowksa, Anna, Demeestere, Jelle, Yassin Mansour, Ossama, Georgiopoulos, Georgios, Nogueira, Raul G., Salerno, Alexander, Wegener, Susanne, Baumgartner, Philipp, Cereda, Carlo W., Bianco, Giovanni, Beyeler, Morin, Arnold, Marcel, Carrera, Emmanuel, Machi, Paolo, Altersberger, Valerian, Bonati, Leo, Gensicke, Henrik, Bolognese, Manuel, Peters, Nils, Wetzel, Stephan, Magriço, Marta, Nuno Ramos, João, Sargento-Freitas, João, Machado, Rita, Maia, Carolina, Machado, Egídio, Paiva-Nunes, Ana, Ferreira, Patrícia, Pinho-e-Melo, Teresa, Carvalho-Dias, Mariana, Paula, André, Alberto Correia, Manuel, Castro, Pedro, Azevedo, Elsa, Albuquerque, Luís, Nuno-Alves, José, Ferreira-Pinto, Joana, Meira, Torcato, Pereira, Liliana, Rodrigues, Miguel, Araújo, André, Rodrigues, Marta, Rocha, Mariana, Pereira-Fonseca, Ângelo, Ribeiro, Luís, Varela, Ricardo, Cappellari, Manuel, Zivelonghi, Cecilia, Sajeva, Giulia, Zini, Andrea, Gentile, Mauro, Forlivesi, Stefano, Migliaccio, Ludovica, Sessa, Maria, Pezzini, Alessandro, Sangalli, Davide, Zedde, Marialuisa, Pascarella, Rosario, Diamanti, Susanna, Beretta, Simone, Schwarz, Ghil, Frisullo, Giovanni, Marcheselli, Simona, Seners, Pierre, Sabben, Candice, Escalard, Simon, Piotin, Michel, Maier, Benjamin, Charbonnier, Guillaume, Vuillier, Fabrice, Legris, Loic, Cuisenier, Pauline, Vodret, Francesca R., Marnat, Gaultier, Liegey, Jean-Sebastien, Sibon, Igor, Flottmann, Fabian, Broocks, Gabriel, Gloyer, Nils-Ole, Bohmann, Ferdinand O., Hendrik Schaefer, Jan, Nolte, Christian H., Audebert, Heinrich, Siebert, Eberhard, Sykora, Marek, Lang, Wilfried, Ferrari, Julia, Mayer-Suess, Lukas, Knoflach, Michael, Gizewski, Elke-Ruth, Stolp, Jeffrey, Stolze, Lotte J., Coutinho, Jonathan M., Nederkoorn, Paul J., van-den-Wijngaard, Ido, de Meris, Joke, Lemmens, Robin, De Raedt, Sylvie, Vandervorst, Fenne, Pierre Rutgers, Matthieu, Guilmot, Antoine, Dusart, Anne, Bellante, Flavio, Calleja-Castaño, Patricia, Ostos, Fernando, Gonzalez-Ortega, Guillermo, Martín-Jiménez, Paloma, García-Madrona, Sebastian, Cruz-Culebras, Antonio, Vera, Rocio, Matute, Maria-Consuelo, Fuentes, Blanca, Alonso-de-Leciñana, María, Rigual, Ricardo, Díez-Tejedor, Exuperio, Pérez-Sánchez, Soledad, Montaner, Joan, Díaz-Otero, Fernando, Perez de la Ossa, Natalia, Flores-Pina, Belén, Muñoz-Narbona, Lucia, Chamorro, Angel, Rodríguez-Vázquez, Alejandro, Renú, Arturo, Ayo-Martin, Oscar, Hernandez-Fernandez, Francisco, Segura, Tomas, Tejada-Meza, Herbert, Hlaing, Thant, See, Isaiah, Simister, Robert, Werring, David J., Saxhaug Kristoffersen, Espen, Nordanstig, Annika, Jood, Katarina, Rentzos, Alexandros, Šimůnek, Libor, Krajíčková, Dagmar, Krajina, Antonín, Mikulík, Robert, Cviková, Martina, Vinklárek, Jan, Školoudík, David, Roubec, Martin, Hurtikova, Eva, Hrubý, Rostislav, Ostry, Svatopluk, Skoda, Ondrej, Pernicka, Marek, Kočí, Lubomír, Eichlová, Zuzana, Jíra, Martin, Kovář, Martin, Panský, Michal, Mencl, Pavel, Paloušková, Hana, Tomek, Aleš, Janský, Petr, Olšerová, Anna, Šrámek, Martin, Havlíček, Roman, Malý, Petr, Trakal, Lukáš, Fiksa, Jan, Slovák, Matěj, Karliński, Michał, Nowak, Maciej, Sienkiewicz-Jarosz, Halina, Bochynska, Anna, Wrona, Pawel, Homa, Tomasz, Sawczynska, Katarzyna, Slowik, Agnieszka, Wlodarczyk, Ewa, Wiącek, Marcin, Tomaszewska-Lampart, Izabella, Sieczkowski, Bartosz, Bartosik-Psujek, Halina, Bilik, Marta, Bandzarewicz, Anna, Dorobek, Malgorzata, Zielińska-Turek, Justyna, Nowakowska-Kotas, Marta, Obara, Krystian, Urbanowski, Paweł, Budrewicz, Sławomir, Guziński, Maciej, Świtońska, Milena, Rutkowska, Iwona, Sobieszak-Skura, Paulina, Łabuz-Roszak, Beata, Dębiec, Aleksander, Staszewski, Jacek, Stępień, Adam, Zwiernik, Jacek, Wasilewski, Grzegorz, Tiu, Cristina, Terecoasă, Elena-Oana, Radu, Razvan-Alexandru, Negrila, Anca, Dorobat, Bogdan, Panea, Cristina, Tiu, Vlad, Petrescu, Simona, Özcan-Özdemir, Atilla, Mahmoud, Mostafa, El-Samahy, Hussam, Abdelkhalek, Hazem, Al-Hashel, Jasem, Ibrahim Ismail, Ismail, Salmeen, Athari, Ghoreishi, Abdoreza, Sabetay, Sergiu, Gross, Hana, Klein, Piers, Abdalkader, Mohamad, Jabbour, Pascal, El Naamani, Kareem, Tjoumakaris, Stavropoula, Abbas, Rawad, Mohamed, Ghada-A., Chebl, Alex, Min, Jiangyong, Hovingh, Majesta, Tsai, Jenny, Khan, Muhib-A., Nalleballe, Krishna, Onteddu, Sanjeeva, Masoud, Hesham E., Michael, Mina, Kaur, Navreet, Maali, Laith, Abraham, Michael, Khandelwal, Priyank, Bach, Ivo, Ong, Melody, Babici, Denis, Khawaja, Ayaz-M., Hakemi, Maryam, Rajamani, Kumar, Cano-Nigenda, Vanessa, Arauz, Antonio, Amaya, Pablo, Llanos, Natalia, Arango, Akemi, Vences, Miguel A., Barrientos, José-Domingo, Caetano, Rayllene, Targa, Rodrigo, Scollo, Sergio, Yalung, Patrick, Nagendra, Shashank, Gaikwad, Abhijit, and Seo, Kwon-Duk

Published
2024
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14. Factors Associated With Fast Early Infarct Growth in Patients With Acute Ischemic Stroke With a Large Vessel Occlusion.

Author

Seners, Pierre, Yuen, Nicole, Olivot, Jean-Marc, Mlynash, Michael, Heit, Jeremy J., Christensen, Soren, Escribano-Paredes, José Bernardo, Carrera, Emmanuel, Strambo, Davide, Michel, Patrik, Salerno, Alexander, Wintermark, Max, Hui Chen, Albucher, Jean-François, Cognard, Christophe, Sibon, Igor, Obadia, Michael, Savatovsky, Julien, Lansberg, Maarten G., and Albers, Gregory W.

Published
2023
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16. Design and Methodology of a Pilot Randomized Controlled Trial of Transcranial Direct Current Stimulation in Acute Middle Cerebral Artery Stroke (STICA)

Author

Estelle Pruvost-Robieux, David Calvet, Wagih Ben Hassen, Guillaume Turc, Angela Marchi, Nicolas Mélé, Pierre Seners, Catherine Oppenheim, Jean-Claude Baron, Jean-Louis Mas, and Martine Gavaret

Subjects
acute ischemic stroke, functional outcome, tDCS, cortical spreading depolarization, peri-infarct depolarizations, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: Stroke is a major cause of death and disability worldwide. The related burden is expected to further increase due to aging populations, calling for more efficient treatment. Ischemic stroke results from a focal reduction in cerebral blood flow due to the sudden occlusion of a brain artery. Ischemic brain injury results from a sequence of pathophysiological events that evolve over time and space. This cascade includes excitotoxicity and peri-infarct depolarizations (PIDs). Focal impairment of cerebral blood flow restricts the delivery of energetics substrates and impairs ionic gradients. Membrane potential is eventually lost, and neurons depolarize. Although recanalization therapies target the ischemic penumbra, they can only rescue the penumbra still present at the time of reperfusion. A promising novel approach is to “freeze” the penumbra until reperfusion occurs. Transcranial direct current stimulation (tDCS) is a non-invasive method of neuromodulation. Based on preclinical evidence, we propose to test the penumbra freezing concept in a clinical phase IIa trial assessing whether cathodal tDCS—shown in rodents to reduce infarction volume—prevents early infarct growth in human acute Middle Cerebral Artery (MCA) stroke, in adjunction to conventional revascularization methods.Methods: This is a monocentric randomized, double-blind, and placebo-controlled trial performed in patients with acute MCA stroke eligible to revascularization procedures. Primary outcome is infarct volume growth on diffusion weighted imaging (DWI) at day 1 relative to baseline. Secondary outcomes include safety and clinical efficacy.Significance: Results from this clinical trial are expected to provide rationale for a phase III study.Clinical trial registration—EUDRACT: 2016-A00160-51

Published
2018
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18. Infarct Core Growth During Interhospital Transfer For Thrombectomy Is Faster At Night.

Author

Seners, Pierre, Mlynash, Michael, Sreekrishnan, Anirudh, Ter Schiphorst, Adrien, Arquizan, Caroline, Costalat, Vincent, Henon, Hilde, Bretzner, Martin, Heit, Jeremy J., Olivot, Jean-Marc, Lansberg, Maarten G., Albers, Gregory W., Schmitt, Perrine, Sablot, Denis, Lalu, Thibault, Bricout, Nicolas, Albucher, Jean-François, Cognard, Christophe, Cordonnier, Charlotte, and Christensen, Soren

Published
2023
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19. Consensus Recommendations for Standardized Data Elements, Scales, and Time Segmentations in Studies of Human Circadian/Diurnal Biology and Stroke.

Author

Saver, Jeffrey L., Klerman, Elizabeth B., Buchan, Alastair M., Calleja, Patricia, Lizasoain, Ignacio, Bahr-Hosseini, Mersedeh, Lee, Sarah, Liebeskind, David S., Mergenthaler, Philipp, Mun, Katherine T., Ning, MingMing, Pelz, David, Ray, David, Rothwell, Peter M., Seners, Pierre, Sreekrishnan, Anirudh, Sung, Eleanor Mina, Tiedt, Steffen, Webb, Alastair J.S., and Wölfer, Teresa A.

Published
2023
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25. Quantification of Penumbral Volume in Association With Time From Stroke Onset in Acute Ischemic Stroke With Large Vessel Occlusion

Author

Seners, Pierre, Yuen, Nicole, Mlynash, Michael, Snyder, Sarah J., Heit, Jeremy J., Lansberg, Maarten G., Christensen, Soren, Albucher, Jean-François, Cognard, Christophe, Sibon, Igor, Obadia, Michael, Savatovsky, Julien, Baron, Jean-Claude, Olivot, Jean-Marc, and Albers, Gregory W.

Abstract

IMPORTANCE: The benefit of reperfusion therapies for acute ischemic stroke decreases over time. This decreasing benefit is presumably due to the disappearance of salvageable ischemic brain tissue (ie, the penumbra). OBJECTIVE: To study the association between stroke onset-to-imaging time and penumbral volume in patients with acute ischemic stroke with a large vessel occlusion. DESIGN, SETTING, AND PARTICIPANTS: A retrospective, multicenter, cross-sectional study was conducted from January 1, 2015, to June 30, 2022. To limit selection bias, patients were selected from (1) the prospective registries of 2 comprehensive centers with systematic use of magnetic resonance imaging (MRI) with perfusion, including both thrombectomy-treated and untreated patients, and (2) 1 prospective thrombectomy study in which MRI with perfusion was acquired per protocol but treatment decisions were made with clinicians blinded to the results. Consecutive patients with acute stroke with intracranial internal carotid artery or first segment of middle cerebral artery occlusion and adequate quality MRI, including perfusion, performed within 24 hours from known symptoms onset were included in the analysis. EXPOSURES: Time from stroke symptom onset to baseline MRI. MAIN OUTCOMES AND MEASURES: Penumbral volume, measured using automated software, was defined as the volume of tissue with critical hypoperfusion (time to maximum >6 seconds) minus the volume of the ischemic core. Substantial penumbra was defined as greater than or equal to 15 mL and a mismatch ratio (time to maximum >6-second volume/core volume) greater than or equal to 1.8. RESULTS: Of 940 patients screened, 516 were excluded (no MRI, n = 19; no perfusion imaging, n = 59; technically inadequate perfusion imaging, n = 75; second segment of the middle cerebral artery occlusion, n = 156; unwitnessed stroke onset, n = 207). Of 424 included patients, 226 (53.3%) were men, and mean (SD) age was 68.9 (15.1) years. Median onset-to-imaging time was 3.8 (IQR, 2.4-5.5) hours. Only 16 patients were admitted beyond 10 hours from symptom onset. Median core volume was 24 (IQR, 8-76) mL and median penumbral volume was 58 (IQR, 29-91) mL. An increment in onset-to-imaging time by 1 hour resulted in a decrease of 3.1 mL of penumbral volume (β coefficient = −3.1; 95% CI, −4.6 to −1.5; P < .001) and an increase of 3.0 mL of core volume (β coefficient = 3.0; 95% CI, 1.3-4.7; P < .001) after adjustment for confounders. The presence of a substantial penumbra ranged from approximately 80% in patients imaged at 1 hour to 70% at 5 hours, 60% at 10 hours, and 40% at 15 hours. CONCLUSIONS AND RELEVANCE: Time is associated with increasing core and decreasing penumbral volumes. Despite this, a substantial percentage of patients have notable penumbra in extended time windows; the findings of this study suggest that a large proportion of patients with large vessel occlusion may benefit from therapeutic interventions.

Published
2023
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26. Endovascular Therapy or Medical Management Alone for Isolated Posterior Cerebral Artery Occlusion: A Multicenter Study

Author

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, Mione, Gioia, Aignatoaie, Andreea, Papassin, Jérémie, Poll, Roxana, Béjot, Yannick, Carrera, Emmanuel, Garnier, Pierre, Michel, Patrik, Saliou, Guillaume, Mordasini, Pasquale, Berthezene, Yves, Costalat, Vincent, Bricout, Nicolas, Albers, Gregory W., Mazighi, Mikael, Turc, Guillaume, Seners, Pierre, Antonenko, Kateryna, Arquizan, Caroline, Benammar, Lynda, Boutet, Claire, Clarençon, Frédéric, Comby, Pierre-Olivier, Desal, Hubert, Detante, Olivier, Eugene, François, Gerardin, Emmanuel, Gory, Benjamin, Kremer, Stéphane, Ledure, Sylvain, Krug, Mathieu, Lapergue, Bertrand, Niclot, Philippe, Magni, Christophe, Obadia, Michael, Ozsancak, Canan, Pico, Fernando, Pilgram-Pastor, Sara, Pop, Raoul, Richard, Sébastien, Rosso, Charlotte, Savatovsky, Julien, Moulin, Solène, Tracol, Clément, and Zbinden, Martin

Published
2023
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27. Perfusion Imaging and Clinical Outcome in Acute Minor Stroke With Large Vessel Occlusion.

Author

Seners, Pierre, Arquizan, Caroline, Fontaine, Louis, Ben Hassen, Wagih, Heldner, Mirjam R., Strambo, Davide, Nagel, Simon, Carrera, Emmanuel, Mechtouff, Laura, McCullough-Hicks, Margy, Mohammaden, Mahmoud H., Cottier, Jean-Philippe, Henon, Hilde, Aignatoaie, Andreea, Laksiri, Nadia, Papassin, Jérémie, Lucas, Ludovic, Garnier, Pierre, Triquenot, Aude, and Mione, Gioia

Published
2022
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28. Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19

Author

Marto, João Pedro, Strambo, Davide, Ntaios, George, Nguyen, Thanh N., Herzig, Roman, Czlonkowska, Anna, Demeestere, Jelle, Mansour, Ossama Yassin, Salerno, Alexander, Wegener, Susanne, Baumgartner, Philipp, Cereda, Carlo W., Bianco, Giovanni, Beyeler, Morin, Arnold, Marcel, Carrera, Emmanuel, Machi, Paolo, Altersberger, Valerian, Bonati, Leo, Gensicke, Henrik, Bolognese, Manuel, Peters, Nils, Wetzel, Stephan, Magriço, Marta, Ramos, João Nuno, Sargento-Freitas, João, Machado, Rita, Maia, Carolina, Machado, Egídio, Nunes, Ana Paiva, Ferreira, Patricia, Pinho e Melo, Teresa, Dias, Mariana Carvalho, Paula, André, Correia, Manuel Alberto, Castro, Pedro, Azevedo, Elsa, Albuquerque, Luís, Alves, José Nuno, Ferreira-Pinto, Joana, Meira, Torcato, Pereira, Liliana, Rodrigues, Miguel, Araujo, Andre Pinho, Rodrigues, Marta, Rocha, Mariana, Pereira-Fonseca, Ângelo, Ribeiro, Luís, Varela, Ricardo, Malheiro, Sofia, Cappellari, Manuel, Zivelonghi, Cecilia, Sajeva, Giulia, Zini, Andrea, Gentile, Mauro, Forlivesi, Stefano, Migliaccio, Ludovica, Sessa, Maria, La Gioia, Sara, Pezzini, Alessandro, Sangalli, Davide, Zedde, Marialuisa, Pascarella, Rosario, Ferrarese, Carlo, Beretta, Simone, Diamanti, Susanna, Schwarz, Ghil, Frisullo, Giovanni, Marcheselli, Simona, Seners, Pierre, Sabben, Candice, Escalard, Simon, Piotin, Michel, Maïer, Benjamin, Charbonnier, Guillaume, Vuillier, Fabrice, Legris, Loïc, Cuisenier, Pauline, Vodret, Francesca R., Marnat, Gaultier, Liegey, Jean-Sebastien, Sibon, Igor, Flottmann, Fabian, Broocks, Gabriel, Gloyer, Nils-Ole, Bohmann, Ferdinand O., Schaefer, Jan Hendrik, Nolte, Christian, Audebert, Heinrich J., Siebert, Eberhard, Sykora, Marek, Lang, Wilfried, Ferrari, Julia, Mayer-Suess, Lukas, Knoflach, Michael, Gizewski, Elke Ruth, Stolp, Jeffrey, Stolze, Lotte J., Coutinho, Jonathan M., Nederkoorn, Paul, van den Wijngaard, Ido, De Meris, Joke, Lemmens, Robin, De Raedt, Sylvie, Vandervorst, Fenne, Rutgers, Matthieu Pierre, Guilmot, Antoine, Dusart, Anne, Bellante, Flavio, Calleja-Castaño, Patricia, Ostos, Fernando, González-Ortega, Guillermo, Martín-Jiménez, Paloma, García-Madrona, Sebastian, Cruz-Culebras, Antonio, Vera, Rocio, Matute, Maria Consuelo, Fuentes, Blanca, Alonso-de-Leciñana, María, Rigual, Ricardo, Díez-Tejedor, Exuperio, Perez-Sanchez, Soledad, Montaner, Joan, Díaz-Otero, Fernando, Pérez-de-la-Ossa, Natalia, Flores-Pina, Belén, Muñoz-Narbona, Lucia, Chamorro, Angel, Rodríguez-Vázquez, Alejandro, Renú, Arturo, Ayo-Martin, Oscar, Hernández-Fernández, Francisco, Segura, Tomas, Tejada-Meza, Herbert, Sagarra-Mur, Daniel, Serrano-Ponz, Marta, Hlaing, Thant, See, Isaiah, Simister, Robert, Werring, David, Kristoffersen, Espen Saxhaug, Nordanstig, Annika, Jood, Katarina, Rentzos, Alexandros, Šimůnek, Libor, Krajíčková, Dagmar, Krajina, Antonín, Mikulik, Robert, Cviková, Martina, Vinklárek, Jan, Školoudík, David, Roubec, Martin, Hurtikova, Eva, Hrubý, Rostislav, Ostry, Svatopluk, Skoda, Ondrej, Pernicka, Marek, Jurak, Lubomir, Eichlová, Zuzana, Jíra, Martin, Kovar, Martin, Panský, Michal, Mencl, Pavel, Palouskova, Hana, Tomek, Aleš, Janský, Petr, Olšerová, Anna, Sramek, Martin, Havlicek, Roman, Malý, Petr, Trakal, Lukáš, Fiksa, Jan, Slovák, Matěj, Karlinski, Michal Adam, Nowak, Maciej, Sienkiewicz-Jarosz, Halina, Bochynska, Anna, Wrona, Pawel, Homa, Tomasz, Sawczynska, Katarzyna, Slowik, Agnieszka, Wlodarczyk, Ewa, Wiacek, Marcin, Tomaszewska-Lampart, Izabella, Sieczkowski, Bartosz, Bartosik-Psujek, Halina, Bilik, Marta, Bandzarewicz, Anna, Dorobek, Malgorzata, Zielinska-Turek, Justyna, Nowakowska-Kotas, Marta, Obara, Krystian, Urbanowski, Paweł, Budrewicz, Slawomir, Guziński, Maciej, Świtońska, Milena, Rutkowska, Iwona, Sobieszak-Skura, Paulina, Labuz-Roszak, Beata M., Debiec, Aleksander, Staszewski, Jacek, Stępień, Adam, Zwiernik, Jacek, Wasilewski, Grzegorz, Tiu, Cristina, Terecoasă, Elena Oana, Radu, Razvan Alexandru, Negrila, Anca, Dorobat, Bogdan, Panea, Cristina, Tiu, Vlad, Petrescu, Simona, Ozdemir, Atilla, Mahmoud, Mostafa, El-Samahy, Hussam, Abdelkhalek, Hazem, Al-Hashel, Jasem, Ismail, Ismail Ibrahim, Salmeen, Athari, Ghoreishi, Abdoreza, Sabetay, Sergiu Ionut, Gross, Hana, Klein, Piers, Abdalkader, Mohamad, Jabbour, Pascal, El Naamani, Kareem, Tjoumakaris, Stavropoula, Abbas, Rawad, Mohamed, Ghada A., Chebl, Alex, Min, Jiangyong, Hovingh, Majesta, Tsai, Jenney P., Khan, Muhib, Nalleballe, Krishna, Onteddu, Sanjeeva, Masoud, Hesham, Michael, Mina, Kaur, Navreet, Maali, Laith, Abraham, Michael G., Khandelwal, Priyank, Bach, Ivo, Ong, Melody, Babici, Denis, Khawaja, Ayaz M., Hakemi, Maryam, Rajamani, Kumar, Cano-Nigenda, Vanessa, Arauz, Antonio, Amaya, Pablo, Llanos, Natalia, Arango, Akemi, Vences, Miguel Ángel, Barrientos Guerra, Jose Dominguo, Caetano, Rayllene, Martins, Rodrigo Targa, Scollo, Sergio Daniel, Yalung, Patrick Matic, Nagendra, Shashank, Gaikwad, Abhijit, Seo, Kwon-Duk, Georgiopoulos, Georgios, Nogueira, Raul G., and Michel, Patrik

Published
2023
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29. Successful thrombectomy is beneficial in patients with pre-stroke disability: Results from an international multicenter cohort study

Author

Ducroux, Célina, Derex, Laurent, Nourredine, Mikaïl, Haesebaert, Julie, Buisson, Marielle, Alesefir, Walid, Boisseau, William, Daneault, Nicole, Deschaintre, Yan, Diestro, Jose Danilo B., Eker, Omer, Eneling, Johanna, Gioia, Laura C., Iancu, Daniella, Jacquin, Grégory, Odier, Céline, Stapf, Christian, Raymond, Jean, Roy, Daniel, Weill, Alain, Lapergue, Bertrand, Poppe, Alexandre Y., Piotin, Michel, Blanc, Raphael, Escalard, Hocine Redjem Simon, Desilles, Jean-Philippe, Delvoye, François, Smajda, Stanislas, Maier, Benjamin, Hebert, Solène, Mazighi, Mikael, Obadia, Mikael, Sabben, Candice, Seners, Pierre, Raynouard, Igor, Corabianu, Ovide, de Broucker, Thomas, Manchon, Eric, Taylor, Guillaume, Ben Maacha, Malek, Thion, Laurie-Anne, Lecler, Augustin, Savatovsky, Julien, Wang, Adrien, Evrard, Serge, Tchikviladze, Maya, Ajili, Nadia, Lapergue, Bertrand, Weisenburger-Lile, David, Gorza, Lucas, Buard, Géraldine, Coskun, Oguzhan, Consoli, Arturo, Di Maria, Federico, Rodesh, Georges, Zimatore, Sergio, Leguen, Morgan, Gratieux, Julie, Pico, Fernando, Rakotoharinandrasana, Haja, Tassan, Philippe, Poll, Roxanna, Marinier, Sylvie, Nighoghossian, Norbert, Riva, Roberto, Eker, Omer, Turjman, Francis, Derex, Laurent, Cho, Tae-Hee, Mechtouff, Laura, Lukaszewicz, Anne Claire, Philippeau, Frédéric, Cakmak, Serkan, Blanc-Lasserre, Karine, Vallet, Anne-Evelyne, Marnat, Gaultier, Gariel, Florent, Barreau, Xavier, Berge, Jérôme, Menegon, Patrice, Sibon, Igor, Lucas, Ludovic, Olindo, Stéphane, Renou, Pauline, Sagnier, Sharmila, Poli, Mathilde, Debruxelles, Sabrina, Rouanet, François, Tourdias, Thomas, Liegey, Jean-Sebastien, Briau, Pierre, Pangon, Nicolas, Bourcier, Romain, Detraz, Lili, Daumas-Duport, Benjamin, Alexandre, Pierre-Louis, Roy, Monica, Lenoble, Cédric, Desal, Hubert, Guillon, Benoît, de Gaalon, Solène, Preterre, Cécile, Gory, Benjamin, Bracard, Serge, Anxionnat, René, Braun, Marc, Derelle, Anne-Laure, Tonnelet, Romain, Liao, Liang, Zhu, François, Schmitt, Emmanuelle, Planel, Sophie, Richard, Sébastien, Humbertjean, Lisa, Mione, Gioia, Lacour, Jean-Christophe, Riou-Comte, Nolwenn, Audibert, Gérard, Voicu, Marcela, Alb, Ionel, Reitter, Marie, Brezeanu, Madalina, Masson, Agnès, Tabarna, Adriana, Podar, Iona, Macian-montoro, Francisco, Saleme, Suzanna, Mounayer, Charbel, Rouchaud, Aymeric, Costalat, Vincent, Arquizan, Caroline, Dargazanli, Cyril, Gascou, Grégory, Lefèvre, Pierre-Henri, Derraz, Imad, Riquelme, Carlos, Gaillard, Nicolas, Mourand, Isabelle, Corti, Lucas, Cagnazzo, Federico, ter Schiphorst, Adrien, Francois, Eugene, Vannier, Stéphane, Ferre, Jean-christophe, Raoult, Helene, Ronziere, Thomas, Lassale, Maria, Paya, Christophe, Gauvrit, Jean-Yves, Tracol, Clément, Langnier-Lemercier, Sophie, Samson, Yves, Rosso, Charlotte, Leger, Anne, Deltour, Sandrine, Clarencon, Frederic, Shotar, Eimad, Spelle, Laurent, Denier, Christian, Chassin, Olivier, Chalumeau, Vanessa, Caroff, Jildaz, Chassin, Olivier, Venditti, Laura, Naggara, Olivier, Hassen, Wagih Ben, Boulouis, Grégoire, Rodriguez-Régent, Christine, Trystram, Denis, Kerleroux, Basile, Turc, Guillaume, Domigo, Valérie, Lamy, Catherine, Birchenall, Julia, Isabel, Clothilde, Lun, François, Viguier, Alain, Cognard, Christophe, Januel, Anne Christine, Olivot, Jean-Marc, Raposo, Nicolas, Bonneville, Fabrice, Albucher, Jean François, Calviere, Lionel, Darcourt, Jean, Tall, Philippe, Bellanger, Guillaume, Fontaine, Louis, Touze, Emmanuel, Barbier, Charlotte, Schneckenburger, Romain, Boulanger, Marion, Cogez, Julien, Guettier, Sophie, Timsit, Serge, Gentric, Jean-christophe, Ognard, Julien, Merrien, Francois Mathias, Wermester, Ozlem Ozkul, Massardier, Evelyne, Papagiannaki, Chrysanthi, Bourdain, Frédéric, Bernady, Patricia, Lagoarde-Segot, Laurent, Cailliez, Hélène, Veunac, Louis, Higue, David, Wolff, Valérie, Pop, Raoul, Beaujeux, Rémi, Dan-Sorin, Mihoc, Manisor, Monica, Le Bras, Anthony, Evain, Sarah, Le Guen, Arnaud, Richter, Sebastian, Hubrecht, Regis, Demasles, Stéphanie, Barroso, Bruno, Sablot, Denis, Farouil, Geoffroy, Tardieu, Maxime, Smadja, Philippe, Aptel, Sabine, and Seiler, Ian

Abstract

Patients with pre-stroke disability, defined as a modified Rankin Scale (mRS) ≥3, were excluded from most trials of endovascular thrombectomy (EVT) for acute stroke. We sought to evaluate the prognostic factors associated with favorable outcome in stroke patients with known disability undergoing EVT, and the impact of successful reperfusion.

Published
2023
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30. 24-Hour Carotid Stent Patency and Outcomes After Endovascular Therapy: A Multicenter Study

Author

Allard, Julien, Delvoye, François, Pop, Raoul, Labreuche, Julien, Maier, Benjamin, Marnat, Gaultier, Sibon, Igor, Zhu, François, Lapergue, Bertrand, Consoli, Arturo, Spelle, Laurent, Denier, Christian, Richard, Sébastien, Piotin, Michel, Gory, Benjamin, Mazighi, Mikael, Blanc, Raphael, Redjem, Hocine, Escalard, Simon, Dessilles, Jean-Philippe, Delvoye, François, Smajda, Stanislas, Maier, Benjamin, Solène, Hebert, Mazighi, Mikael, Obadia, Mikael, Sabben, Candice, Pierre, Seners, Igor, Raynouard, Corabianu, Ovide, de Broucker, Thomas, Manchon, Eric, Taylor, Guillaume, Maacha, Malek Ben, Thion, Laurie-Anne, Augustin, Lecler, Julien, Savatovsjy, Wang, Adrien, Evrard, Serge, Tchikviladze, Maya, Ajili, Nadia, WeisenburgerLile, David, Gorza, Lucas, Buard, Géraldine, Coskun, Oguzhan, Di Maria, Federico, Rodesh, Georges, Zimatore, Sergio, Leguen, Morgan, Gratieux, Julie, Pico, Fernando, Rakotoharinandrasana, Haja, Tassan, Philippe, Poll, Roxanna, Marinier, Sylvie, Barreau, Xavier, Berge, Jérôme, Menegon, Patrice, Lucas, Ludovic, Olindo, Stéphane, Renou, Pauline, Sagnier, Sharmila, Poli, Mathilde, Debruxelles, Sabrina, Rouanet, François, Tourdias, Thomas, Liegey, Jean-Sebastien, Briau, Pierre, Pangon, Nicolas, Coussy, Alexis, Papillon, Lisa, Papaxanthos, Jean, Detraz, Lili, Daumas-Duport, Benjamin, Alexandre, Pierre-Louis, Roy, Monica, Lenoble, Cédric, Desal, Hubert, Guillon, Benoît, de Gaalon, Solène, Preterre, Cécile, Bracard, Serge, Anxionnat, René, Braun, Marc, Derelle, Anne-Laure, Tonnelet, Romain, Liao, Liang, Zhu, François, Schmitt, Emmanuelle, Planel, Sophie, Humbertjean, Lisa, Lacour, Jean-Christophe, Riou-Comte, Nolwenn, Voicu, Marcela, Alb, Lionel, Reitter, Marie, Brezeanu, Madalina, Masson, Agnès, Tabarna, Adriana, Podar, Iona, Macian-Montoro, Francisco, Saleme, Suzanna, Mounayer, Charbel, Rouchaud, Aymeric, Costalat, Vincent, Arquizan, Caroline, Dargazanli, Cyril, Gascou, Grégory, Lefèvre, Pierre-Henri, Derraz, Imad, Riquelme, Carlos, Gaillard, Nicolas, Mourand, Isabelle, Corti, Lucas, Cagnazzo, Federico, Ter Schiphorst, Adrien, Ferre, Jean-Christophe, Raoult, Hélène, Ronziere, Thomas, Lassale, Maria, Paya, Christophe, Gauvrit, Jean-Yves, Tracol, Clément, and Langnier-Lemercier, Sophie

Published
2023
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31. Influence of prior intravenous thrombolysis in patients treated with mechanical thrombectomy for M2 occlusions: insight from the Endovascular Treatment in Ischemic Stroke (ETIS) registry

Author

Le Floch, Agathe, Clarencon, Frédéric, Rouchaud, Aymeric, Kyheng, Maeva, Labreuche, Julien, Sibon, Igor, Boulouis, Gregoire, Gory, Benjamin, Richard, Sébastien, Caroff, Jildaz, Blanc, Raphae¨l, Seners, Pierre, Eker, Omer F, Cho, Tae-Hee, Consoli, Arturo, Bourcier, Romain, guillon, benoit, Dargazanli, Cyril, Arquizan, Caroline, Denier, Christian, Eugene, Francois, Vannier, Stephane, Gentric, Jean-Christophe, Gauberti, Maxime, Naggara, Olivier, Rosso, Charlotte, Turc, Guillaume, Ozkul-Wermester, Ozlem, Cognard, Christophe, Albucher, Jean Francois, Timsit, Serge, Bourdain, Frederic, Le Bras, Anthony, Richter, Sebastian, Moulin, Solène, Pop, Raoul, Heck, Olivier, Moreno, Ricardo, L'Allinec, Vincent, Lapergue, Bertrand, and Marnat, Gaultier

Abstract

BackgroundIntravenous 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.MethodsWe 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.ResultsAmong 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).ConclusionsIn 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.

Published
2023
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32. Thrombectomy in basilar artery occlusions: impact of number of passes and futile reperfusion

Author

de Havenon, Adam, Elhorany, Mahmoud, Boulouis, Gregoire, Naggara, Olivier, Darcourt, Jean, Clarencon, Frédéric, Richard, Sébastien, Marnat, Gaultier, Bourcier, Romain, Sibon, Igor, Arquizan, Caroline, Dargazanli, Cyril, Mai¨er, Benjamin, Seners, Pierre, Lapergue, Bertrand, Consoli, Arturo, Eugene, Francois, Vannier, Stephane, Caroff, Jildaz, Denier, Christian, Boulanger, Marion, Gauberti, Maxime, Rouchaud, Aymeric, Macian, Francisco, Rosso, Charlotte, Turc, Guillaume, Ozkul-Wermester, Ozlem, Papagiannaki, Chrisanthi, Albucher, Jean Francois, Le Bras, Anthony, Evain, Sarah, Wolff, Valerie, Pop, Raoul, Timsit, Serge, Gentric, Jean-Christophe, Bourdain, Frédéric, Veunac, Louis, Fahed, Robert, Finitsis, Stephanos Nikolaos, and Gory, Benjamin

Abstract

BackgroundThe number of mechanical thrombectomy (MT) passes is strongly associated with angiographic reperfusion as well as clinical outcomes in patients with anterior circulation ischemic stroke. However, these associations have not been analyzed in patients with basilar artery occlusion (BAO). We investigated the influence of the number of MT passes on the degree of reperfusion and clinical outcomes, and compared outcome after ≤3 passes versus >3 passes.MethodsWe used data from the prospective multicentric Endovascular Treatment in Ischemic Stroke (ETIS) Registry at 18 sites in France. Patients with BAO treated with MT were included. The primary outcome was a favorable outcome, defined as a modified Rankin Scale score of 0–3 at 90 days. We fit mixed multiple regression models, with center as a random effect.ResultsWe included 275 patients. Successful recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) 2b-3) was achieved in 88.4%, and 41.8% had a favorable outcome. The odds ratio for favorable outcome with each pass above 1 was 0.41 (95% CI 0.23 to 0.73) and for recanalization (mTICI 2b-3) it was 0.70 (95% CI 0.57 to 0.87). In patients with ≤3 passes, the rate of favorable outcome in recanalized versus non-recanalized patients was 50.5% versus 10.0% (p=0.001), while in those with >3 passes it was 16.7% versus 15.2% (p=0.901).ConclusionsWe found that BAO patients had a significant relationship between the number of MT passes and both recanalization and favorable functional outcome. We further found that the benefit of recanalization in BAO patients was significant only when recanalization was achieved within three passes, encouraging at least three passes before stopping the procedure.

Published
2023
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33. Should Patients With Acute Minor Ischemic Stroke With Isolated Internal Carotid Artery Occlusion Be Thrombolysed?

Author

Boulenoir, Naouel, Turc, Guillaume, Ter Schiphorst, Adrien, Heldner, Mirjam R., Strambo, Davide, Laksiri, Nadia, Girard Buttaz, Isabelle, Papassin, Jérémie, Sibon, Igor, Chausson, Nicolas, Michel, Patrik, Rosso, Charlotte, Bourdain, Frédéric, Lamy, Chantal, Weisenburger-Lile, David, Agius, Pierre, Yger, Marion, Obadia, Michael, Sablot, Denis, Legris, Nicolas, Jung, Simon, Pilgram-Pastor, Sara, Henon, Hilde, Bernardaud, Lucy, Arquizan, Caroline, Baron, Jean-Claude, Seners, Pierre, Ben Hassen, Wagih, Lapergue, Bertrand, Lucas, Ludovic, Leys, Didier, Philippeau, Frédéric, Bennani, Omar, Mechtouff, Laura, Klapczynski, Frédéric, Detante, Olivier, Costalat, Vincent, Mione, Gioia, Gazzola, Sébastien, Debiais, Séverine, Cakmak, Serkan, Grigoras, Valer, Denier, Christian, Smadja, Didier, Mounier-Vehier, François, Peres, Roxane, Spelle, Laurent, Bricout, Nicolas, Bracard, Serge, Triquenot, Aude, Lyoubi, Aïcha, Cottier, Jean-Philippe, Duong, Duc-Long, and Ollivier, Camille

Published
2022
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34. Benefit of first‐pass complete reperfusion in thrombectomy is mediated by limited infarct growth

Author

Ben Hassen, W., primary, Tordjman, M., additional, Boulouis, G., additional, Bretzner, M., additional, Bricout, N., additional, Legrand, L., additional, Benzakoun, J., additional, Edjlali, M., additional, Seners, P., additional, Cordonnier, C., additional, Oppenheim, C., additional, Turc, G., additional, Henon, H., additional, and Naggara, O., additional

Published
2020
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36. Influence de la thrombolyse intraveineuse chez les patients traites par thrombectomie mecanique pour une occlusion M2: une analyse du registre etis

Author

Floch, Agathe Le, Clarencon, Frederic, Rouchaud, Aymeric, Khyeng, Maeva, Labreuche, Julien, Sibon, Igor, Boulouis, Gregoire, Gory, Benjamin, Richard, Sebastien, Caroff, Jildaz, Blanc, Raphael, Seners, Pierre, Eker, Omer, Cho, Tae-Hee, Consoli, Arturo, Bourcier, Romain, Guillon, Benoit, Dargazanli, Cyril, Arquizan, Caroline, Denier, Christian, Eugene, Francois, Vannier, Stephanie, Gentric, Jean-Christophe, Gauberti, Maxime, Nagarra, Olivier, Rosso, Charlotte, Turc, Guillaume, Ozkul-Wermester, Ozlem, Cognard, Christophe, Albucher, Jean-Francois, Timsit, Serge, Bourdain, Frederic, Bras, Anthony Le, Richter, Sebastian, Moulin, Solene, Pop, Raoul, Heck, Olivier, Moreno, Ricardo, L'Allinec, Vincent, Lapergue, Bertrand, and Marnat, Gaultier

Abstract

– Le bénéfice de la thrombolyse intraveineuse (TIV) préalable chez les patients traités par thrombectomie mécanique (TM) pour une occlusion d'un gros vaisseau a récemment été remise en question par plusieurs essais randomisés. Ces études incluaient cependant peu de patients avec des occlusions M2. Nous avons étudié l'influence de la TIV préalable chez les patients traités pas TM pour une occlusion M2, comparativement à la TM seule.

Published
2023
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37. Functional Outcome, Recanalization, and Hemorrhage Rates After Large Vessel Occlusion Stroke Treated With Tenecteplase Before Thrombectomy.

Author

Gerschenfeld, Gaspard, Smadja, Didier, Turc, Guillaume, Olindo, Stephane, Laborne, François-Xavier, Yger, Marion, Caroff, Jildaz, Gonçalves, Bruno, Seners, Pierre, Cantier, Marie, l'Hermitte, Yann, Aghasaryan, Manvel, Alecu, Cosmin, Marnat, Gaultier, Ben Hassen, Wagih, Kalsoum, Erwah, Clarençon, Frédéric, Piotin, Michel, Spelle, Laurent, and Denier, Christian

Published
2021
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38. Relevance of Brain Regions' Eloquence Assessment in Patients With a Large Ischemic Core Treated With Mechanical Thrombectomy.

Author

Kerleroux, Basile, Benzakoun, Joseph, Janot, Kévin, Dargazanli, Cyril, Eraya, Dimitri Daly, Ben Hassen, Wagih, Zhu, François, Gory, Benjamin, Hak, Jean-Francois, Perot, Charline, Detraz, Lili, Bourcier, Romain, Aymeric, Rouchaud, Forestier, Géraud, Marnat, Gaultier, Gariel, Florent, Mordasini, Pasquale, Seners, Pierre, Turc, Guillaume, and Kaesmacher, Johannes

Published
2021
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39. Impact of COVID‐19 on thrombus composition and response to thrombolysis: Insights from a monocentric cohort population of COVID‐19 patients with acute ischemic stroke

Author

Desilles, Jean‐Philippe, Solo Nomenjanahary, Mialitiana, Consoli, Arturo, Ollivier, Véronique, Faille, Dorothée, Bourrienne, Marie‐Charlotte, Hamdani, Mylène, Dupont, Sébastien, Di Meglio, Lucas, Escalard, Simon, Maier, Benjamin, Blanc, Raphael, Piotin, Michel, Lapergue, Bertrand, Ajzenberg, Nadine, Vasse, Marc, Mazighi, Mikael, Ho‐Tin‐Noé, Benoît, Désilles, Jean‐Philippe, Mazighi, Mikael, Piotin, Michel, Blanc, Raphael, Redjem, Hocine, Smajda, Stanislas, Seners, Pierre, Escalard, Simon, Delvoye, Francois, Maier, Benjamin, Hebert, Solene, Ben Maacha, Malek, Hamdani, Mylene, Sabben, Candice, Obadia, Michael, Deschildre, Catherine, Lapergue, Bertrand, Consoli, Arturo, Rodesch, Georges, Maria, Federico, Coskun, Okuzan, Lopez, Delphine, Bourcier, Romain, Detraz, Lili, Desal, Hubert, Roy, Monica, Clavier, Delphine, Marnat, Gaultier, Gariel, Florent, Lucas, Ludovic, Sibon, Igor, Eugene, Francois, Vannier, Stéphane, Ferre, Jean‐Christophe, LeBras, Anthony, Raoult, Hélène, Paya, Christophe, Gauvrit, Jean‐Yves, Richard, Sébastien, Gory, Benjamin, Barbier, Charlotte, Vivien, Denis, Touze, Emmanuel, Gauberti, Maxime, Blaizot, Gaetane, Ifergan, Héloïse, Herbreteau, Denis, Bibi, Richard, Janot, Kevin, Charron, Vladimir, and Boulouis, Grégoire

Abstract

Resistance to fibrinolysis, levels of procoagulant/antifibrinolytic neutrophil extracellular traps (NETs), and the severity of acute ischemic stroke (AIS) are increased by COVID‐19. Whether NETs are components of AIS thrombi from COVID‐19 patients and whether COVID‐19 impacts the susceptibility of these thrombi to thrombolytic treatments remain unknown, however.

Published
2022
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41. Early neurological deterioration following thrombolysis for minor stroke with isolated internal carotid artery occlusion.

Author

Boulenoir, N., Turc, G., Henon, H., Laksiri, N., Mounier‐Véhier, F., Girard Buttaz, I., Duong, D.‐L., Papassin, J., Yger, M., Triquenot, A., Lyoubi, A., Ter Schiphorst, A., Denier, C., Baron, J.‐C., Seners, P., Ben Hassen, Wagih, Lapergue, Bertrand, Lamy, Chantal, Lucas, Ludovic, and Philippeau, Frédéric

Subjects
INTERNAL carotid artery, THROMBOLYTIC therapy, STROKE, CIRCLE of Willis, PATIENTS' attitudes, TRANSIENT ischemic attack
Abstract

Background and purpose: Better understanding the incidence, predictors and mechanisms of early neurological deterioration (END) following intravenous thrombolysis (IVT) for acute stroke with mild symptoms and isolated internal carotid artery occlusion (iICAo) may inform therapeutic decisions. Methods: From a multicenter retrospective database, we extracted all patients with both National Institutes of Health Stroke Scale (NIHSS) score <6 and iICAo (i.e. not involving the Willis circle) on admission imaging, intended for IVT alone. END was defined as ≥4 NIHSS points increase within 24 h. END and no‐END patients were compared for (i) pre‐treatment clinical and imaging variables and (ii) occurrence of intracranial occlusion, carotid recanalization and parenchymal hemorrhage on follow‐up imaging. Results: Seventy‐four patients were included, amongst whom 22 (30%) patients experienced END. Amongst pre‐treatment variables, suprabulbar carotid occlusion was the only admission predictor of END following stepwise variable selection (odds ratio = 4.0, 95% confidence interval: 1.3–12.2; P = 0.015). On follow‐up imaging, there was no instance of parenchymal hemorrhage, but an intracranial occlusion was now present in 76% vs. 0% of END and no‐END patients, respectively (P < 0.001), and there was a trend toward higher carotid recanalization rate in END patients (29% vs. 9%, P = 0.07). As compared to no‐END, END was strongly associated with a poor 3‐month outcome. Conclusions: Early neurological deterioration is a frequent and highly deleterious event after IVT for minor stroke with iICAo, and is of thromboembolic origin in three out of four patients. The strong association with iICAo site—largely a function of underlying stroke etiology—may point to a different response of the thrombus to IVT. These findings suggest END may be preventable in this setting. [ABSTRACT FROM AUTHOR]

Published
2021
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42. Benefit of first‐pass complete reperfusion in thrombectomy is mediated by limited infarct growth.

Author

Ben Hassen, W., Tordjman, M., Boulouis, G., Bretzner, M., Bricout, N., Legrand, L., Benzakoun, J., Edjlali, M., Seners, P., Cordonnier, C., Oppenheim, C., Turc, G., Henon, H., and Naggara, O.

Subjects
DIFFUSION magnetic resonance imaging, THROMBECTOMY, REPERFUSION, CEREBRAL infarction
Abstract

Background and Purpose: The number of clot retrieval attempts required to achieve complete reperfusion by mechanical thrombectomy impacts functional outcome in acute ischaemic stroke (AIS). Complete reperfusion [expanded Treatment In Cerebral Infarction (eTICI) score = 3] at first pass (FP), is associated with the highest rates of favorable outcome compared to complete reperfusion by multiple passes. The aim of the present study was to investigate the relationship between FP complete reperfusion and infarct growth (IG). Methods: Anterior AIS patients with baseline and 24‐h diffusion‐weighted magnetic resonance imaging were included from two prospective registries. IG was measured by voxel‐based segmentation of initial and 24‐h diffusion‐weighted imaging lesions. IG and favorable 3‐month modified Rankin Scale (mRS) score (≤ 2) were compared between patients in whom complete reperfusion (eTICI 3) was achieved with a single pass (FP group) and those for whom multiple passes were required (MP group), after matching for confounding factors. Mediation analysis was performed to examine the association between FP and 3‐month mRS score, with IG as mediating variable. Results: A total of 200 patients were included, of whom 118 (28.9%) had FP complete reperfusion. In case–control analysis, the FP group had lower IG than the MP group [8.7 (5.4–12.9) ml vs. 15.2 (11–22.6) ml, respectively; P = 0.03). Favorable outcome was higher in the FP population compared to a matched MP population (70.9% vs. 53.2%, respectively; P = 0.04). FP compete reperfusion (eTICI 3) was independently associated with favorable outcome in multivariable regression analysis [odds ratio 1.86, 95% confidence interval (CI) 1.01–4.39; P = 0.04]. The effect of complete reperfusion at FP on functional outcome was explained by limited IG in mediation analysis [indirect effect: −0.32 (95% CI −0.47 to −0.09)]. Conclusion: Complete reperfusion at FP is independently associated with significant decrease in IG compared to complete reperfusion by multiple attempts, explaining better functional outcomes. [ABSTRACT FROM AUTHOR]

Published
2021
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44. Larger ischemic cores and poor collaterals among large vessel occlusions presenting in the late evening.

Author

Sreekrishnan, Anirudh, Tiedt, Steffen, Seners, Pierre, Yuen, Nicole, Olivot, Jean-Marc, Mlynash, Michael, Lansberg, Maarten G., Heit, Jeremy J., Lee, Sarah, Michel, Patrik, Strambo, Davide, Salerno, Alexander, Paredes, José Bernardo Escribano, Carrera, Emmanuel, and Albers, Gregory W.

Abstract

Components critical to cerebral perfusion have been noted to oscillate over a 24-h cycle. We previously reported that ischemic core volume has a diurnal relationship with stroke onset time when examined as dichotomized epochs (i.e. Day, Evening, Night) in a cohort of over 1,500 large vessel occlusion (LVO) patients. In this follow-up analysis, our goal was to explore if there is a sinusoidal relationship between ischemic core, collateral status (as measured by HIR), and stroke onset time. We retrospectively examined collection of LVO patients with baseline perfusion imaging performed within 24 h of stroke onset from four international comprehensive stroke centers. Both ischemic core volume and HIR, were utilized as the primary radiographic parameters. To evaluate for differences in these parameters over a continuous 24-h cycle, we conducted a sinusoidal regression analysis after linearly regressing out the confounders age and time to imaging. A total of 1506 LVO cases were included, with a median ischemic core volume of 13.0 cc (IQR: 0.0-42.0) and median HIR of 0.4 (IQR: 0.2-0.6). Ischemic core volume varied by stroke onset time in the unadjusted (p = 0.001) and adjusted (p = 0.003) sinusoidal regression analysis with a peak in core volume around 7:45PM. HIR similarly varied by stroke onset time in the unadjusted (p = 0.004) and adjusted (p = 0.002) models with a peak in HIR values at around 8:18PM. The results suggest that critical factors to the development of the ischemic core vary by stroke onset time and peak around 8PM. When placed in the context of prior studies, strongly suggest a diurnal component to the development of the ischemic core. [ABSTRACT FROM AUTHOR]

Published
2023
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45. Prediction of Early Neurological Deterioration in Individuals With Minor Stroke and Large Vessel Occlusion Intended for Intravenous Thrombolysis Alone

Author

Seners, Pierre, Ben Hassen, Wagih, Lapergue, Bertrand, Arquizan, Caroline, Heldner, Mirjam R., Henon, Hilde, Perrin, Claire, Strambo, Davide, Cottier, Jean-Philippe, Sablot, Denis, Girard Buttaz, Isabelle, Tamazyan, Ruben, Preterre, Cécile, Agius, Pierre, Laksiri, Nadia, Mechtouff, Laura, Béjot, Yannick, Duong, Duc-Long, Mounier-Vehier, François, Mione, Gioia, Rosso, Charlotte, Lucas, Ludovic, Papassin, Jérémie, Aignatoaie, Andreea, Triquenot, Aude, Carrera, Emmanuel, Niclot, Philippe, Obadia, Alexandre, Lyoubi, Aïcha, Garnier, Pierre, Crainic, Nicolae, Wolff, Valérie, Tracol, Clément, Philippeau, Frédéric, Lamy, Chantal, Soize, Sébastien, Baron, Jean-Claude, and Turc, Guillaume

Abstract

IMPORTANCE: The best reperfusion strategy in patients with acute minor stroke and large vessel occlusion (LVO) is unknown. Accurately predicting early neurological deterioration of presumed ischemic origin (ENDi) following intravenous thrombolysis (IVT) in this population may help to select candidates for immediate transfer for additional thrombectomy. OBJECTIVE: To develop and validate an easily applicable predictive score of ENDi following IVT in patients with minor stroke and LVO. DESIGN, SETTING, AND PARTICIPANTS: This multicentric retrospective cohort included 729 consecutive patients with minor stroke (National Institutes of Health Stroke Scale [NIHSS] score of 5 or less) and LVO (basilar artery, internal carotid artery, first [M1] or second [M2] segment of middle cerebral artery) intended for IVT alone in 45 French stroke centers, ie, including those who eventually received rescue thrombectomy because of ENDi. For external validation, another cohort of 347 patients with similar inclusion criteria was collected from 9 additional centers. Data were collected from January 2018 to September 2019. MAIN OUTCOMES AND MEASURES: ENDi, defined as 4 or more points’ deterioration on NIHSS score within the first 24 hours without parenchymal hemorrhage on follow-up imaging or another identified cause. RESULTS: Of the 729 patients in the derivation cohort, 335 (46.0%) were male, and the mean (SD) age was 70 (15) years; of the 347 patients in the validation cohort, 190 (54.8%) were male, and the mean (SD) age was 69 (15) years. In the derivation cohort, the median (interquartile range) NIHSS score was 3 (1-4), and the occlusion site was the internal carotid artery in 97 patients (13.3%), M1 in 207 (28.4%), M2 in 395 (54.2%), and basilar artery in 30 (4.1%). ENDi occurred in 88 patients (12.1%; 95% CI, 9.7-14.4) and was strongly associated with poorer 3-month outcomes, even in patients who underwent rescue thrombectomy. In multivariable analysis, a more proximal occlusion site and a longer thrombus were independently associated with ENDi. A 4-point score derived from these variables—1 point for thrombus length and 3 points for occlusion site—showed good discriminative power for ENDi (C statistic = 0.76; 95% CI, 0.70-0.82) and was successfully validated in the validation cohort (ENDi rate, 11.0% [38 of 347]; C statistic = 0.78; 95% CI, 0.70-0.86). In both cohorts, ENDi probability was approximately 3%, 7%, 20%, and 35% for scores of 0, 1, 2 and 3 to 4, respectively. CONCLUSIONS AND RELEVANCE: The substantial ENDi rates observed in these cohorts highlights the current debate regarding whether to directly transfer patients with IVT-treated minor stroke and LVO for additional thrombectomy. Based on the strong associations observed, an easily applicable score for ENDi risk prediction that may assist decision-making was derived and externally validated.

Published
2021
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46. Do Fluid-Attenuated Inversion Recovery Vascular Hyperintensities Represent Good Collaterals before Reperfusion Therapy?

Author

Mahdjoub, E., primary, Turc, G., additional, Legrand, L., additional, Benzakoun, J., additional, Edjlali, M., additional, Seners, P., additional, Charron, S., additional, Ben Hassen, W., additional, Naggara, O., additional, Meder, J.-F., additional, Mas, J.-L., additional, Baron, J.-C., additional, and Oppenheim, C., additional

Published
2017
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47. MT-DRAGON score for outcome prediction in acute ischemic stroke treated by mechanical thrombectomy within 8 hours

Author

Ben Hassen, Wagih, Raynaud, Nicolas, Bricout, Nicolas, Boulouis, Gregoire, Legrand, Laurence, Ferrigno, Marc, Kazemi, Apolline, Bretzner, Martin, Soize, Sebastien, Farhat, Wassim, Seners, Pierre, Turc, Guillaume, Zuber, Mathieu, Oppenheim, Catherine, Cordonnier, Charlotte, Naggara, Olivier, and Henon, Hilde

Abstract

ObjectivesThe MRI-DRAGON score includes clinical and MRI parameters and demonstrates a high specificity in predicting 3 month outcome in patients with acute ischemic stroke (AIS) treated with intravenous tissue plasminogen activator (IV tPA). The aim of this study was to adapt this score to mechanical thrombectomy (MT) in a large multicenter cohort.MethodsConsecutive cases of AIS treated by MT between January 2015 and December 2017 from three stroke centers were reviewed (n=1077). We derived the MT-DRAGON score by keeping all variables of the MRI-DRAGON score (age, initial National Institutes of Health Stroke Scale score, glucose level, pre-stroke modified Rankin Scale (mRS) score, diffusion weighted imaging-Alberta Stroke Program Early CT score ≤5) and considering the following variables: time to groin puncture instead of onset to IV tPA time and occlusion site. Unfavorable 3 month outcome was defined as a mRS score >2. Score performance was evaluated by c statistics and an external validation was performed.ResultsAmong 679 included patients (derivation and validation cohorts, n=431 and 248, respectively), an unfavorable outcome was similar between the derivation (51.5%) and validation (58.1%, P=0.7) cohorts, and was significantly associated with all MT-DRAGON parameters in the multivariable analysis. The c statistics for unfavorable outcome prediction was 0.83 (95%CI 0.79 to 0.88) in the derivation and 0.8 (95%CI 0.75 to 0.86) in the validation cohort. All patients (n=55) with an MT-DRAGONscore ≥11 had an unfavorable outcome and 60/63 (95%) patients with an MT-DRAGON score ≤2 points had a favorable outcome.ConclusionThe MT-DRAGON score is a simple tool, combining admission clinical and radiological parameters that can reliably predict 3 month outcome after MT.

Published
2020
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48. White matter hyperintensity burden in patients with ischemic stroke treated with thrombectomy.

Author

Boulouis, Grégoire, Bricout, Nicolas, Benhassen, Wagih, Ferrigno, Marc, Turc, Guillaume, Bretzner, Martin, Benzakoun, Joseph, Seners, Pierre, Personnic, Thomas, Legrand, Laurence, Trystram, Denis, Rodriguez-Regent, Christine, Charidimou, Andreas, Rost, Natalia S., Bracard, Serge, Cordonnier, Charlotte, Oppenheim, Catherine, Naggara, Olivier, and Henon, Hilde

Published
2019
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49. Better Collaterals Are Independently Associated With Post-Thrombolysis Recanalization Before Thrombectomy.

Author

Seners, Pierre, Roca, Pauline, Legrand, Laurence, Turc, Guillaume, Cottier, Jean-Philippe, Cho, Tae-Hee, Arquizan, Caroline, Bracard, Serge, Ozsancak, Canan, Ben Hassen, Wagih, Naggara, Olivier, Lion, Stéphanie, Debiais, Séverine, Berthezene, Yves, Costalat, Vincent, Richard, Sébastien, Magni, Christophe, Mas, Jean-Louis, Baron, Jean-Claude, and Oppenheim, Catherine

Published
2019
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50. Thrombus Length Predicts Lack of Post-Thrombolysis Early Recanalization in Minor Stroke With Large Vessel Occlusion.

Author

Seners, Pierre, Delepierre, Julie, Turc, Guillaume, Henon, Hilde, Piotin, Michel, Arquizan, Caroline, Cho, Tae-Hee, Lapergue, Bertrand, Cottier, Jean-Philippe, Richard, Sébastien, Legrand, Laurence, Bricout, Nicolas, Mazighi, Mikaël, Dargazanli, Cyril, Nighoghossian, Norbert, Consoli, Arturo, Debiais, Séverine, Bracard, Serge, Naggara, Olivier, and Leclerc, Xavier

Published
2019
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