Acute endovascular treatment of patients with ischemic stroke from intracranial large vessel occlusion and extracranial carotid dissection
العنوان: | Acute endovascular treatment of patients with ischemic stroke from intracranial large vessel occlusion and extracranial carotid dissection |
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المؤلفون: | Compagne, K.C.J., Goldhoorn, R.B., Uyttenboogaart, M., Oostenbrugge, R.J. van, Zwam, W.H. van, Doormaal, P.J. van, Dippel, D.W.J., Lugt, A. van der, Emmer, B.J., Es, A.C.G.M. van, Majoie, C.B.L.M., Roos, Y.B.W.E.M., Boiten, J., Vos, J.A., Jansen, I.G.H., Mulder, M.J.H.L., Kappelhof, M., Schonewille, W.J., Coutinho, J.M., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L., Roozenbeek, B., Bruijn, S.F. de, Dijk, L.C. van, Worp, H.B. van der, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Postma, A.A., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Bot, J., Boiten, G.J., Flach, H.Z., Lingsma, H.F., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinseveld, W., Berkhemer, O.A., Boers, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Treurniet, K.M., Tolhuijsen, M.L., Alves, H., MR CLEAN Investigators |
المساهمون: | Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, MUMC+: MA Neurologie (3), RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: DA BV AIOS Radiologie (9), Radiology & Nuclear Medicine, Neurology, Public Health |
المصدر: | Frontiers in Neurology, 10:102. Frontiers Media SA Frontiers in neurology, 10(FEB):102. Frontiers Media S.A. Frontiers in Neurology, 10. Frontiers Media S.A. Frontiers in Neurology, 10:102, 1-9. Frontiers Media S.A. Frontiers in Neurology, 10 MR CLEAN Registry Investigators 2019, ' Acute Endovascular Treatment of Patients With lschemic Stroke From Intracranial Large Vessel Occlusion and Extracranial Carotid Dissection ', Frontiers in Neurology, vol. 10 . https://doi.org/10.3389/fneur.2019.00102 Frontiers in Neurology, 10:102. Frontiers Media S.A. Frontiers in Neurology Frontiers in Neurology, Vol 10 (2019) |
سنة النشر: | 2019 |
مصطلحات موضوعية: | endovascular treatment, medicine.medical_specialty, carotid dissection, CAD, 030204 cardiovascular system & hematology, lcsh:RC346-429, Carotid artery dissection, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Occlusion, SCORE, medicine, ischemic stroke, MANAGEMENT, REPERFUSION, ACUTE ISCHEMIC-STROKE, cardiovascular diseases, Endovascular treatment, Contraindication, lcsh:Neurology. Diseases of the nervous system, Original Research, tandem lesion, business.industry, MECHANICAL THROMBECTOMY, ARTERY DISSECTION, medicine.disease, Neurology, thrombectomy, Carotid artery occlusion, Cardiology, Neurology (clinical), Carotid dissection, business, 030217 neurology & neurosurgery, Large vessel occlusion, INTRAARTERIAL TREATMENT |
الوصف: | Introduction: Carotid artery dissection (CAD) and atherosclerotic carotid artery occlusion (ACAO) are major causes of a tandem occlusion in patients with intracranial large vessel occlusion (LVO). Presence of tandem occlusions may hamper intracranial access and potentially increases the risk of procedural complications of endovascular treatment (EVT). Our aim was to assess neurological, functional and technical outcome and complications of EVT for intracranial LVO in patients with CAD in comparison to patients with ACAO and to patients without CAD or ACAO.Methods: We analyzed data of the MR CLEAN trial intervention arm and MR CLEAN Registry, acquired in 16 Dutch EVT-centers. Primary outcome was the change in stroke severity by comparing the National Institute of Health Stroke Scale (NIHSS) score at 24-48 h after treatment vs. baseline. Secondary outcomes included reperfusion rate and symptomatic intracranial hemorrhage (sICH). We compared outcomes and complications between patients with CAD vs. patients with ACAO and patients without CAD or ACAO.Results: In total, we identified 74 (4.7%) patients with CAD, 92 (5.9%) patients with ACAO and 1398 (89.4%) patients without CAD or ACAO. Neurological improvement at short-term after EVT in patients with CAD was significantly better compared to ACAO (raw mean -5 vs. mean -1 NIHSS point; p = 0.03) and did not differ compared to patients without CAD or ACAO (-4 NIHSS points; p = 0.62). Rates of successful reperfusion in patients with CAD (47%) was comparable to patients with ACAO (47%; p = 1.00), but was less often achieved compared to patients without CAD or ACAO (58%; p = 0.08). Occurrence of sICH did not differ significantly between CAD patients (5%) and ACAO (11%; p = 0.33) or without CAD/ACAO (6%; p = 1.00).Conclusion: EVT in patients with intracranial LVO due to CAD results in neurological improvement comparable to patients without tandem occlusions. Therefore, carotid artery dissection by itself should not be a contraindication for endovascular treatment in stroke patients with intracranial large vessel occlusion. Although more challenging endovascular procedures are to be suspected in both patients with CAD or ACAO, accurate distinction between CAD and ACAO might influence clinical decision making as better clinical outcome can be expected in patients with CAD. |
وصف الملف: | application/pdf |
اللغة: | English |
تدمد: | 1664-2295 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::170fbb1f01b08b1a2ec67b14e580a0e9 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85065835194&origin=inward |
حقوق: | OPEN |
رقم الأكسشن: | edsair.doi.dedup.....170fbb1f01b08b1a2ec67b14e580a0e9 |
قاعدة البيانات: | OpenAIRE |
تدمد: | 16642295 |
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