Emergent Carotid Stenting Plus Thrombectomy After Thrombolysis in Tandem Strokes

Mohammad Anadani; Alejandro Spiotta; Ali Alawieh; Francis Turjman; Michel Piotin; Diogo Haussen; Raul Nogueira; Panagiotis Papanagiotou; Adnan Siddiqui; Bertrand Lapergue; Franziska Dorn; Christophe Cognard; Marc Ribo; Marios Psychogios; Marc Antoine Labeyrie; Mikael Mazighi; Alessandra Biondi; René Anxionnat; Serge Bracard; Sébastien Richard; Benjamin Gory; Jonathan Andrew Grossberg; Adrien Guenego; Julien Darcourt; Isabelle Vukasinovic; Elisa Pomero; Jason Davies; Leonardo Renieri; Corentin Hecker; Maria Muchada Muchada; Arturo Consoli; Georges Rodesch; Emmanuel Houdart; Raymond Turner; Aquilla Turk; Imran Chaudry; Johanna Lockau; Andreas Kastrup; Raphaël Blanc; Hocine Redjem; Daniel Behme; Hussain Shallwani; Maurer Christopher; Gioia Mione; Lisa Humbertjean; Jean-Christophe Lacour; François Zhu; Anne-Laure Derelle; Romain Tonnelet; Liang Liao

doi:10.1161/STROKEAHA.118.024733

Journal Articles Stroke Year : 2019

Emergent Carotid Stenting Plus Thrombectomy After Thrombolysis in Tandem Strokes

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Mohammad Anadani

Function : Author
PersonId : 801468
ORCID : 0000-0002-7813-2949

Medical University of South Carolina [Charleston]

Alejandro Spiotta

Function : Author

Medical University of South Carolina [Charleston]

Ali Alawieh

Function : Author

Medical University of South Carolina [Charleston]

Francis Turjman

Function : Author

Département de Neuroradiologie [Centre Hospitalier Lyon Sud - HCL]

Michel Piotin

Function : Author
PersonId : 767048
ORCID : 0000-0002-1354-4328
IdRef : 104505605

Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]

Diogo Haussen

Function : Author

Emory University School of Medicine

Raul Nogueira

Function : Author

Emory University School of Medicine

Panagiotis Papanagiotou

Function : Author

Klinikum Bremen-Mitte

Adnan Siddiqui

Function : Author

University at Buffalo [SUNY]

Bertrand Lapergue

Function : Author

Hôpital Foch [Suresnes]

Franziska Dorn

Function : Author

Klinikum der Universität [München]

Christophe Cognard

Function : Author

Service Neuroradiologie Diagnostique et Thérapeutique [CHU Toulouse]

Marc Ribo

Function : Author
PersonId : 757305
ORCID : 0000-0001-9242-043X

Vall d'Hebron University Hospital [Barcelona]

Marios Psychogios

Function : Author

University Medical Center Göttingen

Marc Antoine Labeyrie

Function : Author

Service de Neuroradiologie [CHU Lariboisière]

Mikael Mazighi

Function : Author
PersonId : 786644
ORCID : 0000-0003-0911-8999
IdRef : 069189781

Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]

Alessandra Biondi

Function : Author

Centre Hospitalier Régional Universitaire de Besançon

René Anxionnat

Function : Author
PersonId : 755707
ORCID : 0000-0001-6112-0661
IdRef : 075878445

Imagerie Adaptative Diagnostique et Interventionnelle

Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]

Serge Bracard

Function : Author

Imagerie Adaptative Diagnostique et Interventionnelle

Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]

Sébastien Richard

Function : Author
PersonId : 776166
ORCID : 0000-0002-0945-5656

Défaillance Cardiovasculaire Aiguë et Chronique

Service de neurologie [CHRU Nancy]

Benjamin Gory

Function : Author
PersonId : 762859
ORCID : 0000-0001-8424-4464

Imagerie Adaptative Diagnostique et Interventionnelle

Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]

Jonathan Andrew Grossberg

Function : Author

Adrien Guenego

Function : Author

Julien Darcourt

Function : Author

Isabelle Vukasinovic

Function : Author

Elisa Pomero

Function : Author

Jason Davies

Function : Author

Leonardo Renieri

Function : Author

Corentin Hecker

Function : Author

Maria Muchada Muchada

Function : Author

Arturo Consoli

Function : Author
PersonId : 786640
ORCID : 0000-0001-6640-8541

Imagerie Adaptative Diagnostique et Interventionnelle

Hôpital Foch [Suresnes]

Georges Rodesch

Function : Author

Emmanuel Houdart

Function : Author

Raymond Turner

Function : Author

Aquilla Turk

Function : Author

Imran Chaudry

Function : Author

Johanna Lockau

Function : Author

Andreas Kastrup

Function : Author

Raphaël Blanc

Function : Author

Hocine Redjem

Function : Author
PersonId : 779240
ORCID : 0000-0002-6943-9922

Daniel Behme

Function : Author

Hussain Shallwani

Function : Author

Maurer Christopher

Function : Author

Gioia Mione

Function : Author

Lisa Humbertjean

Function : Author

Jean-Christophe Lacour

Function : Author

François Zhu

Function : Author
PersonId : 1376787
IdHAL : francois-zhu

Imagerie Adaptative Diagnostique et Interventionnelle

Anne-Laure Derelle

Function : Author

Romain Tonnelet

Function : Author

Liang Liao

Function : Author

Abstract

Background and Purpose— Emergent carotid artery stenting plus mechanical thrombectomy is an effective treatment for acute ischemic stroke patients with tandem occlusion of the anterior circulation. However, there is limited data supporting the safety of this approach in patients treated with prior intravenous thrombolysis (IVT). We aimed to investigate the safety of emergent carotid artery stenting-mechanical thrombectomy approach in stroke patient population treated with prior IVT. Methods— We assessed patients with acute ischemic stroke because of atherosclerotic tandem occlusion that were treated with emergent carotid artery stenting-mechanical thrombectomy approach from the multicenter observational Thrombectomy in Tandem Lesions registry. Patients were divided into 2 groups based on pretreatment IVT (IVT versus no-IVT). Intracerebral hemorrhages were classified according to the European Cooperative Acute Stroke Study II criteria. Results— Among 205 patients included in the present study, 125 (60%) received prior IVT. Time from symptoms onset-to-groin puncture was shorter (234±100 versus 256±234 minutes; P =0.002), and heparin use was less in the IVT group (14% versus 35%; P <0.001); otherwise, there was no difference in the baseline characteristics. There was no significant difference between the IVT and no-IVT groups in the rate of symptomatic intracerebral hemorrhage (5% versus 8%; P =0.544), parenchymal hematoma type 1 to 2 (15% versus 18%; P =0.647), successful reperfusion (modified Thrombolysis in Cerebral Ischemia 2b–3), or 90-day favorable outcome (modified Rankin Scale score of 0–2 at 90 days). The 90-day all-cause mortality rate was significantly lower in the IVT group (8% versus 20%; P =0.017). After adjusting for covariates, IVT was not associated with symptomatic intracerebral hemorrhage or 90-day mortality. Conclusions— Emergent carotid artery stenting-mechanical thrombectomy approach was not associated with an increased risk of hemorrhagic complications in tandem occlusion patients who received IVT before the intervention.

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Medical Imaging Nuclear medicine Human health and pathology

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https://hal.univ-lorraine.fr/hal-03268700

Submitted on : Wednesday, June 23, 2021-1:53:20 PM

Last modification on : Monday, May 27, 2024-3:20:15 PM

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hal-03268700 , version 1 (23-06-2021)

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HAL Id : hal-03268700 , version 1
DOI : 10.1161/STROKEAHA.118.024733
PUBMED : 31577899

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Mohammad Anadani, Alejandro Spiotta, Ali Alawieh, Francis Turjman, Michel Piotin, et al.. Emergent Carotid Stenting Plus Thrombectomy After Thrombolysis in Tandem Strokes. Stroke, 2019, 50 (8), pp.2250-2252. ⟨10.1161/STROKEAHA.118.024733⟩. ⟨hal-03268700⟩

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Emergent Carotid Stenting Plus Thrombectomy After Thrombolysis in Tandem Strokes

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