Impact of Reperfusion for Nonagenarians Treated by Mechanical Thrombectomy - Université de Lorraine
Journal Articles Stroke Year : 2019

Impact of Reperfusion for Nonagenarians Treated by Mechanical Thrombectomy

Eve Drouard-de Rousiers (1) , Ludovic Lucas (2) , Sébastien Richard (3, 4) , Arturo Consoli (1, 5) , Mikaël Mazighi (6) , Julien Labreuche (7) , Maéva Kyheng (7) , Benjamin Gory (5, 8) , Cyril Dargazanli (9) , Caroline Arquizan (10) , Gaultier Marnat (11) , Raphaël Blanc (6) , Hubert Desal (12) , Romain Bourcier (12) , Igor Sibon (11) , Bertrand Lapergue (1) , Michel Piotin , Simon Escalard , Jean-Philippe Desilles , Hocine Redjem , Gabriele Ciccio , Stanislas Smajda , Robert Fahed , Mikael Obadia , Candice Sabben , Ovide Corabianu , Thomas de Broucker , Didier Smadja , Sonia Alamowitch , Olivier Ille , Eric Manchon , Pierre-Yves Garcia , Guillaume Taylor , Malek Ben Maacha , Adrien Wang , Serge Evrard , Maya Tchikviladze , Vadim Afanasiev , Nadia Ajili , Bénédicte Sensenbrenner , Oguzhan Coskun , Federico Di Maria , Georges Rodesch , Bruno del Sette , Riccardo Russo , Katsuhiro Mizutani , Morgan Leguen , Julie Gratieux , Fernando Pico , Haja Rakotoharinandrasana , Philippe Tassan , Roxanna Poll , Norbert Nighoghossian , Roberto Riva , Omer Eker , Francis Turjman , Laurent Derex , Tae-Hee Cho , Laura Mechtouff , Anne Claire Lukaszewicz , Frédéric Philippeau , Serkan Cakmak , Karine Blanc-Lasserre , Anne-Evelyne Vallet , Florent Gariel , Xavier Barreau , Jérôme Berge , Louis Veunac , Patrice Menegon , Stéphane Olindo , Pauline Renou , Sharmila Sagnier , Mathilde Poli , Sabrina Debruxelles , Lili Detraz , Benjamin Daumas-Duport , Pierre-Louis Alexandre , Monica Roy , Cédric Lenoble , Vincent L’allinec , Jean-Baptiste Girot , Solène de Gaalon , Benoit Guillon , Serge Bracard (5) , René Anxionnat (5) , Marc Braun (5) , Anne-Laure Derelle , Romain Tonnelet , Liang Liao , François Zhu (5) , Emmanuelle Schmitt , Sophie Planel , Lisa Humbertjean , Gioia Mione , Jean-Christophe Lacour , Mathieu Bonnerot , Nolwenn Riou-Comte , Isabelle Costa , Anne Chatelain , Vincent Costalat , Grégory Gascou , Pierre-Henri Lefèvre , Imad Derraz , Carlos Riquelme , Nicolas Gaillard , Isabelle Mourand Et Lucas Corti , Eugene Francois , Stéphane Vannier
Eve Drouard-de Rousiers
  • Function : Author
Hôpital Foch [Suresnes]
Ludovic Lucas
  • Function : Author
Hôpital Pellegrin
Sébastien Richard
Service de neurologie [CHRU Nancy]
Centre d'investigation clinique plurithématique Pierre Drouin [Nancy]
Arturo Consoli
Hôpital Foch [Suresnes]
Imagerie Adaptative Diagnostique et Interventionnelle
Mikaël Mazighi
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Julien Labreuche
  • Function : Author
Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Maéva Kyheng
Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Benjamin Gory
Imagerie Adaptative Diagnostique et Interventionnelle
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Cyril Dargazanli
Neuroradiologie [Hôpital Gui de Chauliac]
Caroline Arquizan
  • Function : Author
Département de neurologie [Montpellier]
Gaultier Marnat
Service de neurologie [Bordeaux]
Raphaël Blanc
  • Function : Author
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Hubert Desal
Service de neurologie [Nantes]
Romain Bourcier
  • Function : Author
Service de neurologie [Nantes]
Igor Sibon
Service de neurologie [Bordeaux]
Bertrand Lapergue
  • Function : Author
Hôpital Foch [Suresnes]
Michel Piotin
Simon Escalard
Jean-Philippe Desilles
  • Function : Author
Hocine Redjem
Gabriele Ciccio
Stanislas Smajda
  • Function : Author
Robert Fahed
Mikael Obadia
  • Function : Author
Candice Sabben
  • Function : Author
Ovide Corabianu
  • Function : Author
Thomas de Broucker
  • Function : Author
Didier Smadja
  • Function : Author
Sonia Alamowitch
  • Function : Author
Olivier Ille
  • Function : Author
Eric Manchon
  • Function : Author
Pierre-Yves Garcia
  • Function : Author
Guillaume Taylor
  • Function : Author
Malek Ben Maacha
  • Function : Author
Adrien Wang
  • Function : Author
Serge Evrard
  • Function : Author
Maya Tchikviladze
  • Function : Author
Vadim Afanasiev
  • Function : Author
Nadia Ajili
  • Function : Author
Bénédicte Sensenbrenner
  • Function : Author
Oguzhan Coskun
  • Function : Author
Federico Di Maria
  • Function : Author
Georges Rodesch
  • Function : Author
Bruno del Sette
  • Function : Author
Riccardo Russo
  • Function : Author
Katsuhiro Mizutani
  • Function : Author
Morgan Leguen
  • Function : Author
Julie Gratieux
  • Function : Author
Fernando Pico
  • Function : Author
Haja Rakotoharinandrasana
  • Function : Author
Philippe Tassan
  • Function : Author
Roxanna Poll
  • Function : Author
Norbert Nighoghossian
Roberto Riva
  • Function : Author
Omer Eker
Francis Turjman
  • Function : Author
Laurent Derex
Tae-Hee Cho
Laura Mechtouff
Anne Claire Lukaszewicz
  • Function : Author
Frédéric Philippeau
  • Function : Author
Serkan Cakmak
  • Function : Author
Karine Blanc-Lasserre
  • Function : Author
Anne-Evelyne Vallet
  • Function : Author
Florent Gariel
Xavier Barreau
  • Function : Author
Jérôme Berge
  • Function : Author
Louis Veunac
  • Function : Author
Patrice Menegon
  • Function : Author
Stéphane Olindo
  • Function : Author
Pauline Renou
  • Function : Author
Sharmila Sagnier
Mathilde Poli
  • Function : Author
Sabrina Debruxelles
  • Function : Author
Lili Detraz
  • Function : Author
Benjamin Daumas-Duport
  • Function : Author
Pierre-Louis Alexandre
  • Function : Author
Monica Roy
  • Function : Author
Cédric Lenoble
  • Function : Author
Vincent L’allinec
  • Function : Author
Jean-Baptiste Girot
Solène de Gaalon
  • Function : Author
Benoit Guillon
  • Function : Author
Serge Bracard
  • Function : Author
Imagerie Adaptative Diagnostique et Interventionnelle
René Anxionnat
Imagerie Adaptative Diagnostique et Interventionnelle
Marc Braun
  • Function : Author
Imagerie Adaptative Diagnostique et Interventionnelle
Anne-Laure Derelle
  • Function : Author
Romain Tonnelet
  • Function : Author
Liang Liao
  • Function : Author
François Zhu
Imagerie Adaptative Diagnostique et Interventionnelle
Emmanuelle Schmitt
Sophie Planel
  • Function : Author
Lisa Humbertjean
  • Function : Author
Gioia Mione
  • Function : Author
Jean-Christophe Lacour
  • Function : Author
Mathieu Bonnerot
  • Function : Author
Nolwenn Riou-Comte
  • Function : Author
Isabelle Costa
  • Function : Author
Anne Chatelain
  • Function : Author
Vincent Costalat
Grégory Gascou
  • Function : Author
Pierre-Henri Lefèvre
  • Function : Author
Imad Derraz
Carlos Riquelme
Nicolas Gaillard
Isabelle Mourand Et Lucas Corti
  • Function : Author
Eugene Francois
  • Function : Author
Stéphane Vannier
  • Function : Author

Abstract

Background and Purpose— Nonagenarians represent a growing stroke population characterized by a higher frailty. Although endovascular therapy (ET) is a cornerstone of the management of acute ischemic stroke related to large vessel occlusion, the benefit of reperfusion among nonagenarians is poorly documented. We aimed to assess the impact of ET-related reperfusion on the functional outcome of reperfusion in this elderly population. Methods— A retrospective analysis of clinical and imaging data from all patients aged over 90 included in the ETIS (Endovascular Treatment in Ischemic Stroke) registry between October 2013 and April 2018 was performed. Association between post-ET reperfusion and favorable (modified Rankin Scale [0–2] or equal to prestroke value) and good (modified Rankin Scale [0–3] or equal to prestroke value) outcome were evaluated. Demographic and procedural predictors of functional outcome, including the first-pass effect, were evaluated. Results were adjusted for center, admission National Institutes of Health Stroke Scale, and use of intravenous thrombolysis. Results— Among the 124 nonagenarians treated with ET, those with successful reperfusion had the lowest 90-day modified Rankin Scale (odds ratio, 3.26; 95% CI, 1.04–10.25). Only patients with successful reperfusion after the first pass (n=53, 56.7%) had a reduced 90-day mortality (odds ratio, 0.15; 95% CI, 0.05–0.45) and an increased rate of good outcome (odds ratio, 4.55; 95% CI, 1.38–15.03). No increase in the rate of intracranial hemorrhage was observed among patients successfully reperfused. Conclusions— Successful reperfusion improves the functional outcome of nonagenarians who should not be excluded from ET. The first-pass effect should be considered in the procedural management of this frail population.

Domains

Medical Imaging Nuclear medicine Human health and pathology

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https://hal.univ-lorraine.fr/hal-03268970

Submitted on : Wednesday, June 23, 2021-3:55:17 PM

Last modification on : Wednesday, September 11, 2024-8:16:03 PM

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Dates and versions

hal-03268970 , version 1 (23-06-2021)

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Eve Drouard-de Rousiers, Ludovic Lucas, Sébastien Richard, Arturo Consoli, Mikaël Mazighi, et al.. Impact of Reperfusion for Nonagenarians Treated by Mechanical Thrombectomy. Stroke, 2019, 50 (11), pp.3164-3169. ⟨10.1161/STROKEAHA.119.026448⟩. ⟨hal-03268970⟩

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UNIV-NANTES UNIV-LORRAINE UNIV-MONTPELLIER IADI-UL UNIV-LILLE BMS-UL NANTES-UNIVERSITE
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