RT Journal Article
SR Electronic
T1 Endovascular reperfusion of M2 occlusions in acute ischemic stroke reduced disability and mortality: ETIS Registry results
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 444
OP 449
DO 10.1136/neurintsurg-2021-017380
VO 14
IS 5
A1 Patricio Muszynski
A1 Mohammad Anadani
A1 Sébastien Richard
A1 Gaultier Marnat
A1 Romain Bourcier
A1 Igor Sibon
A1 Cyril Dargazanli
A1 Caroline Arquizan
A1 Benjamin Maïer
A1 Raphaël Blanc
A1 Bertrand Lapergue
A1 Arturo Consoli
A1 Francois Eugene
A1 Stephane Vannier
A1 Laurent Spelle
A1 Christian Denier
A1 Marion Boulanger
A1 Maxime Gauberti
A1 Suzana Saleme
A1 Francisco Macian
A1 Frédéric Clarençon
A1 Charlotte Rosso
A1 Olivier Naggara
A1 Guillaume Turc
A1 Ozlem Ozkul-Wermester
A1 Chrisanthi Papagiannaki
A1 Alain Viguier
A1 Christophe Cognard
A1 Anthony Le Bras
A1 Sarah Evain
A1 Valérie Wolff
A1 Raoul Pop
A1 Serge Timsit
A1 Jean-Christophe Gentric
A1 Frédéric Bourdain
A1 Louis Veunac
A1 Benjamin Gory
A1 Stephanos Nikolaos Finitsis
A1 ,
YR 2022
UL http://jnis.bmj.com/content/14/5/444.abstract
AB Background The predictors of successful reperfusion and the effect of reperfusion after endovascular treatment (EVT) for M2 occlusions have not been well studied. We aimed to identify predictors of successful reperfusion and the effect of reperfusion on outcomes of EVT for M2 occlusions in current practice.Methods Patients with acute ischemic stroke due to isolated M2 occlusions who were enrolled in the prospective multicenter Endovascular Treatment in Ischemic Stroke (ETIS) Registry in France between January 2015 and March 2020 were included. The primary outcome was a favorable outcome, defined as modified Rankin Scale (mRS) score of 0–2 at 90 days. Successful reperfusion was defined as an improvement of ≥1 points in the modified Thrombolysis In Cerebral Infarction score between the first and the last intracranial angiogram.Results A total of 458 patients were included (median National Institutes of Health Stroke Scale (NIHSS) score 14; 61.4% received prior intravenous thrombolysis). Compared with the non-reperfused patients, reperfused patients had an increased rate of excellent outcome (OR 2.3, 95% CI 0.98 to 5.36; p=0.053), favorable outcome (OR 2.79, 95% CI 1.31 to 5.93; p=0.007), and reduced 90-day mortality (OR 0.39, 95% CI 0.19 to 0.79; p<0.01). Admission NIHSS score was the only predictor of successful reperfusion. First-line strategy was not a predictor of successful reperfusion or favorable outcome, but the use of a stent retriever, alone or with an aspiration catheter, was associated with higher rates of procedural complications and 90-day mortality.Conclusions Successful reperfusion of M2 occlusions reduced disability and mortality. However, safety is a concern, especially if the procedure failed.All data relevant to the study are included in the article or uploaded as supplemental information. Endovascular Treatment in Ischemic Stroke (ETIS) Investigators.