Successful Thrombectomy Improves Functional Outcome in Tandem Occlusions with a Large Ischemic Core - Archive ouverte HAL
Journal Articles World Neurosurgery Year : 2023

Successful Thrombectomy Improves Functional Outcome in Tandem Occlusions with a Large Ischemic Core

Benjamin Gory (1) , Stephanos Nikolaos Finitsis (2) , Jean Philippe Desilles (3) , Arturo Consoli (4, 5) , Mikael Mazighi (3) , Gaultier Marnat (6) , Igor Sibon (6) , Raoul Pop (7) , Nicolas Raposo (8, 9) , Valérie Wolff (10) , Christophe H. Cognard (11) , Śebastien Richard , Solène Moulin (12) , Sébastien Soize (12) , Bertrand Lapergue (4, 5) , Adrien Wang (5) , Oguzhan Coskun (13) , Federico Maria (14) , Silvia Pizzuto (13) , Alessandro Sgreccia (13) , Charline Benoit (15) , Lucas Gorza (5) , David Weisenburger-Lile (5) , Waliyde Jabeur (16) , Tchikviladze Maia , Serge Evrard (17) , Georges L. Rodesch , Raphaël Blanc (18) , Michaël Alexandre Obadia , Michel P. Piotin (19) , Pierre Seners (19) , Stanislas J. Smajda , Simon Escalard (19) , Benjamin Maier , Candice Sabben , Hocine Redjem , Grace Adwan , François Delvoye , Amira Al Raaisi , William Boisseau , Omer Faruk Eker , Tae-Hee Cho , Laurent Derex , Julia Fontaine , Laura Mechtouff , Norbert Nighoghossian , Elodie Ong , Lucie Rascle , Roberto Riva , Françis Turjman , Morgane Laubacher , Mehdi Beyragued , Yves Berthezene , Marc R. Hermier , Ameli Roxanna , Alexandre Bani-Sadr , Andrea Filip , Matteo Cappucci , Romain Bourcier , Benjamin Daumas Duport , Pierre Louis Alexandre , Cédric Lenoble , Solène De Gaalon , Benoît Guillon , Cécile Preterre , Guillaume Tessier , Arthur Lionnet , Lisa Humbertjean-Selton , René Anxionnat , Anne Laure Derelle , Liang Liao , Emmanuelle Schmitt , Sophie Planel , Gioia Mione , Jean Christophe Lacour , Marian Douarinou , Emilien Micard , Bailiang Chen , Gérard B. Audibert , Agnès Masson , Lionel Alb , Marine Beaumont , Adriana Tabarna , Marcela Voicu , Grégoire Barthel , Iona Podar , Madalina Brezeanu , Marie Reitter , François Zhu , Jean Sébastien Liegey , Pierre Briau , Lisa Papillon , Xavier Barreau , Jean Papaxanthos , Jerome Berge , Sabrina Debruxelles , Stéphane Olindo , Mathilde Poli , Pauline Renou , Sharmila Sagnier , Thomas Tourdias , Thomas Courret , Ludovic Lucas , Maĺgorzata Milnerowicz , Cyril Dargazanli , Vincent Costalat , Isabelle Mourand , Caroline Arquizan , Lucas Corti , Ter Schiphorst , Cagnazzo Federico , Imad Derraz , Mehdi Mahmoudi , Pierre Henri Lefevre , Grégory Gascou , Laurent Spelle , Jildaz Caroff , Christian Denier , Vanessa Chalumeau , Cristian Mihalea , Augustin P. Ozanne , Léon Ikka , Olivier Chassin , Sophie Gallas , Laura Venditti , Jonathan Cortese , Jean Christophe Ferre , Stéphane Vannier , Thomas Ronziere , Maria Veronica Lassalle , Jean Yves Gauvrit , Clément Tracol , Abdelghani Fakhreddine Boustia , Cécile Malrain , Edouard Beaufreton , Thibaut Lapotre , Quentin Alias , Julien Hissier , Maud Guillen , François Eugene , Cyril Chivot , Audrey Courselle , Elisa Ouin , Chantal Lamy , Kévin Delaforge , Manuel Fernandez , Jérémie Vial , Quentin Laferte , Xavier Desdoit , Serge Timsit (20) , Aurore Jourdain , Jean Christophe Gentric , J. Ognard , Irina Viakhireva , Jordan Coris , Sabine Prud'Hon , François Mathias Merrien , Denis Marechal , Marie Bruguet , Pierre Yves Rousseau , Philippe Goas , Marion Boulanger , Emmanuel Touze , Denis Vivien , Charlotte N. Barbier , Romain Schneckenburger , Fabrizio Salaris , Julien Cogez , Sophie Guettier , Estelle La Porte , Jean Bouchart , Charbel Mounayer , Aymeric M. Rouchaud , Suzana Saleme , Géraud Forestier , Frédéric Clarencon , Charlotte Rosso , Sara Julia Leder , Flore Baronnet , Sophie Crozier , Anne Leger , Kévin Premat , Shotar Eimad , Stéphanie Lenck , Nader Antoine Sourour , Laure Bottin , Sam Ghazanfari , Marion Yger , Sonia Alamowitch , Stephen Delorme , Aymeric Wittwer , Christine Vassilev , Olivier N. Naggara , G. Turc , Wagih Ben Hassen , Basile Kerleroux , Denis Trystram , Christine Rodriguez-Regent , Ozlem Ozkul-Wermester , Chrysanthi Papagiannaki , Evelyne Guégan Massardier , Aude Bagan Triquenot , Margaux Lefebvre , Julien Burel , Alain Viguier , Anne Christine Januel , Jean François Albucher , Lionel Calviere , Jean Darcourt , Fabrice Bonneville , Guillaume Bellanger , Philippe Tall , Claire Thalamas , Thomas Geerearts , Antoine Faurie Grepon , Frédéric D.Ric Bourdain , Patricia Bernady , Guillaume Ballan , Stéphanie Bannier , Emmanuel Ellie , Olivier Flabeau , Julia Potenza , Antoine Soulages , Laurent Lagoarde-Segot , Hélène Cailliez , David Higue , Louis Veunac , Anthony Lebras , Sarah Adam , Benoit Pegat , Arnaud Le Guen , François Chedeville , Jérémy Jouan , Stéphanie Demasles , Johann Sebastian Richter , Bruno Thierry Barroso , Camille Dahan , Alexis Gonnet , Régis Hubrecht , Zoé Lepine , Hélène Castagnet , Raluca Marasescu , Olivier Heck , Pauline Cuisenier , Olivier Detante , Isabelle Favre Wiki , Clémentine Bonaz , Katia Garambois , Loïc Legris , Adrian Kastler , Kamel Boubagra , Corentin Berthet , Stéphane Charara , Véronique Quenardelle , Valérie Lauer , Irène Nora Pierre-Paul , Malwina Trzeciak , Hua Vi Tuan , Paolo Pagano , Alexandre Doucet , Christophe Gelmini , Pierre François Manceau , Laurentiu Paiusan , Isabelle Serre , Thi Ngoc Phuong Nguyen , Maher Sahnoun , Nathalie Caucheteux , Anna Ferrier , Abderrahim Zerroug , Ricardo Moreno , Emmanuel Chabert , Elie Lteif , Nathalie Bourgois , Marie Raquin , Anne Pasco-Papon , Jean Baptiste Girot , Aldéric Lecluse , Sophie Godard , Vincent l'Allinec , Kévin Janot , Richard Edwige Bibi , Marie Gaudron , Arnaud Bretonniere , Mariam Annan , Héloïse Ifergan , Grégoire Boulouis , Marco Pasi , Séverine Debiais , Elisabeth Molinier , Anthony Wietrich , Valérie Ruche , Karine Lavandier , Yannick Bejot , Brivale Lemogne , Fédéric Ricolfi , Laura Baptiste , Pierre Thouant , Gauthier Duloquin , Pierre Olivier Comby , Guillaume Charbonnier , Louise Bonnet , Nicolas Raybaud , Benjamin Bouamra , T. Moulin , Alessandra Biondi , Nicolas Raposo (8) , Jean-Marc Olivot (9)
Mikael Mazighi
Śebastien Richard
  • Function : Author
Tchikviladze Maia
  • Function : Author
Georges L. Rodesch
  • Function : Author
Michaël Alexandre Obadia
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Stanislas J. Smajda
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Benjamin Maier
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Candice Sabben
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Hocine Redjem
Grace Adwan
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François Delvoye
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Amira Al Raaisi
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William Boisseau
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Omer Faruk Eker
Tae-Hee Cho
Laurent Derex
Julia Fontaine
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Laura Mechtouff
Norbert Nighoghossian
Elodie Ong
Lucie Rascle
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Roberto Riva
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Françis Turjman
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Morgane Laubacher
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Mehdi Beyragued
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Yves Berthezene
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Marc R. Hermier
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Ameli Roxanna
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Alexandre Bani-Sadr
Andrea Filip
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Matteo Cappucci
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Romain Bourcier
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Benjamin Daumas Duport
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Pierre Louis Alexandre
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Cédric Lenoble
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Solène De Gaalon
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Benoît Guillon
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Cécile Preterre
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Guillaume Tessier
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Arthur Lionnet
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Lisa Humbertjean-Selton
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René Anxionnat
  • Function : Author
Anne Laure Derelle
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Liang Liao
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Emmanuelle Schmitt
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Sophie Planel
  • Function : Author
Gioia Mione
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Jean Christophe Lacour
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Marian Douarinou
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Emilien Micard
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Bailiang Chen
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Gérard B. Audibert
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Agnès Masson
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Lionel Alb
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Marine Beaumont
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Adriana Tabarna
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Marcela Voicu
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Grégoire Barthel
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Iona Podar
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Madalina Brezeanu
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Marie Reitter
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François Zhu
Jean Sébastien Liegey
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Pierre Briau
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Lisa Papillon
  • Function : Author
Xavier Barreau
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Jean Papaxanthos
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Jerome Berge
Sabrina Debruxelles
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Stéphane Olindo
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Mathilde Poli
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Pauline Renou
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Sharmila Sagnier
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Thomas Tourdias
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Thomas Courret
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Ludovic Lucas
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Maĺgorzata Milnerowicz
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Cyril Dargazanli
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Vincent Costalat
  • Function : Author
Isabelle Mourand
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Caroline Arquizan
  • Function : Author
Lucas Corti
  • Function : Author
Ter Schiphorst
  • Function : Author
Cagnazzo Federico
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Imad Derraz
  • Function : Author
Mehdi Mahmoudi
  • Function : Author
Pierre Henri Lefevre
  • Function : Author
Grégory Gascou
  • Function : Author
Laurent Spelle
  • Function : Author
Jildaz Caroff
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Christian Denier
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Vanessa Chalumeau
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Cristian Mihalea
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Augustin P. Ozanne
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Léon Ikka
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Olivier Chassin
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Sophie Gallas
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Laura Venditti
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Jonathan Cortese
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Jean Christophe Ferre
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Stéphane Vannier
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Thomas Ronziere
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Maria Veronica Lassalle
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Jean Yves Gauvrit
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Clément Tracol
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Abdelghani Fakhreddine Boustia
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Cécile Malrain
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Edouard Beaufreton
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Thibaut Lapotre
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Quentin Alias
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Julien Hissier
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Maud Guillen
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François Eugene
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Cyril Chivot
Audrey Courselle
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Elisa Ouin
Chantal Lamy
Kévin Delaforge
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Manuel Fernandez
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Jérémie Vial
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Quentin Laferte
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Xavier Desdoit
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Aurore Jourdain
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Jean Christophe Gentric
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J. Ognard
Irina Viakhireva
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Jordan Coris
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Sabine Prud'Hon
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François Mathias Merrien
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Denis Marechal
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Marie Bruguet
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Pierre Yves Rousseau
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Philippe Goas
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Marion Boulanger
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Emmanuel Touze
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Denis Vivien
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Charlotte N. Barbier
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Romain Schneckenburger
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Fabrizio Salaris
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Julien Cogez
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Sophie Guettier
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Estelle La Porte
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Jean Bouchart
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Charbel Mounayer
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Aymeric M. Rouchaud
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Suzana Saleme
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Géraud Forestier
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Frédéric Clarencon
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Charlotte Rosso
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Sara Julia Leder
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Flore Baronnet
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Sophie Crozier
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Anne Leger
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Kévin Premat
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Shotar Eimad
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Stéphanie Lenck
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Nader Antoine Sourour
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Laure Bottin
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Sam Ghazanfari
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Marion Yger
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Sonia Alamowitch
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Stephen Delorme
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Aymeric Wittwer
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Christine Vassilev
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Olivier N. Naggara
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G. Turc
Wagih Ben Hassen
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Basile Kerleroux
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Denis Trystram
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Christine Rodriguez-Regent
Ozlem Ozkul-Wermester
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Chrysanthi Papagiannaki
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Evelyne Guégan Massardier
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Aude Bagan Triquenot
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Margaux Lefebvre
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Julien Burel
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Alain Viguier
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Anne Christine Januel
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Jean François Albucher
Lionel Calviere
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Jean Darcourt
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Fabrice Bonneville
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Guillaume Bellanger
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Philippe Tall
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Claire Thalamas
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Thomas Geerearts
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Antoine Faurie Grepon
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Frédéric D.Ric Bourdain
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Patricia Bernady
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Guillaume Ballan
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Emmanuel Ellie
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Olivier Flabeau
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Julia Potenza
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Antoine Soulages
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Laurent Lagoarde-Segot
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Hélène Cailliez
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David Higue
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Louis Veunac
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Anthony Lebras
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Sarah Adam
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Benoit Pegat
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Arnaud Le Guen
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François Chedeville
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Jérémy Jouan
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Stéphanie Demasles
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Johann Sebastian Richter
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Bruno Thierry Barroso
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Camille Dahan
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Alexis Gonnet
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Régis Hubrecht
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Zoé Lepine
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Hélène Castagnet
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Raluca Marasescu
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Olivier Heck
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Pauline Cuisenier
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Olivier Detante
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Clémentine Bonaz
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Christophe Gelmini
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Laurentiu Paiusan
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Isabelle Serre
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Maher Sahnoun
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Nathalie Caucheteux
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Anna Ferrier
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Abderrahim Zerroug
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Ricardo Moreno
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Emmanuel Chabert
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Elie Lteif
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Nathalie Bourgois
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Marie Raquin
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Anne Pasco-Papon
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Jean Baptiste Girot
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Aldéric Lecluse
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Sophie Godard
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Vincent l'Allinec
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Kévin Janot
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Richard Edwige Bibi
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Marie Gaudron
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Arnaud Bretonniere
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Mariam Annan
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Héloïse Ifergan
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Grégoire Boulouis
Marco Pasi
Séverine Debiais
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Elisabeth Molinier
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Anthony Wietrich
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Valérie Ruche
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Karine Lavandier
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Yannick Bejot
Brivale Lemogne
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Fédéric Ricolfi
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Laura Baptiste
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Pierre Thouant
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Gauthier Duloquin
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Pierre Olivier Comby
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Guillaume Charbonnier
Louise Bonnet
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Nicolas Raybaud
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Benjamin Bouamra
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Abstract

Background: Emergent stenting in tandem occlusions and mechanical thrombectomy (MT) of acute ischemic stroke related to large vessel occlusion (LVO-AIS) with a large core are tested independently. We aim to assess the impact of reperfusion with MT in patients with LVO-AIS with a large core and a tandem occlusion and to compare the safety of reperfusion between large core with tandem and nontandem occlusions in current practice. Methods: We analyzed data of all consecutive patients included in the prospective Endovascular Treatment in Ischemic Stroke Registry in France between January 2015 and March 2023 who presented with a pretreatment ASPECTS (Alberta Stroke Program Early CT Score) of 0–5 and angiographically proven tandem occlusion. The primary end point was a favorable outcome defined by a modified Rankin Scale (mRS) score of 0–3 at 90 days. Results: Among 262 included patients with a tandem occlusion and ASPECTS 0–5, 203 patients (77.5%) had a successful reperfusion (modified Thrombolysis in Cerebral Infarction grade 2b-3). Reperfused patients had a favorable shift in the overall mRS score distribution (adjusted odds ratio [aOR], 1.57 [1.22–2.03]; P < 0.001), higher rates of mRS score 0–3 (aOR, 7.03 [2.60–19.01]; P < 0.001) and mRS score 0–2 at 90 days (aOR, 3.85 [1.39–10.68]; P = 0.009) compared with nonreperfused. There was a trend between the occurrence of successful reperfusion and a decreased rate of symptomatic intracranial hemorrhage (aOR, 0.5 [0.22–1.13]; P = 0.096). Similar safety outcomes were observed after large core reperfusion in tandem and nontandem occlusions. Conclusions: Successful reperfusion was associated with a higher rate of favorable outcome in large core LVO-AIS with a tandem occlusion, with a safety profile similar to nontandem occlusion.
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hal-04195189 , version 1 (04-12-2024)

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Benjamin Gory, Stephanos Nikolaos Finitsis, Jean Philippe Desilles, Arturo Consoli, Mikael Mazighi, et al.. Successful Thrombectomy Improves Functional Outcome in Tandem Occlusions with a Large Ischemic Core. World Neurosurgery, 2023, 178, pp.e282-e291. ⟨10.1016/j.wneu.2023.07.043⟩. ⟨hal-04195189⟩
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