Successful thrombectomy is beneficial in patients with pre-stroke disability: Results from an international multicenter cohort study.

Célina Ducroux, Laurent Derex, Mikaïl Nourredine, Julie Haesebaert, Marielle Buisson, Walid Alesefir, William Boisseau, Nicole Daneault, Yan Deschaintre, Jose Danilo B. Diestro, Omer Eker, Johanna Eneling, Laura C. Gioia, Daniella Iancu, Grégory Jacquin, Céline Odier, Christian Stapf, Jean Raymond, Daniel Roy, Alain Weill, Bertrand Lapergue, Alexandre Y. Poppe, Michel Piotin, Raphael Blanc, Hocine Redjem Simon Escalard, Jean-Philippe Desilles, François Delvoye, Stanislas Smajda, Benjamin Maier, Solène Hebert, Mikael Mazighi, Mikael Obadia, Candice Sabben, Pierre Seners, Igor Raynouard, Ovide Corabianu, Thomas de Broucker, Eric Manchon, Guillaume Taylor, Malek Ben Maacha, Laurie-Anne Thion, Augustin Lecler, Julien Savatovsky, Adrien Wang, Serge Evrard, Maya Tchikviladze, Nadia Ajili, David Weisenburger-Lile, Lucas Gorza, Géraldine Buard, Oguzhan Coskun, Arturo Consoli, Federico Di Maria, Georges Rodesh, Sergio Zimatore, Morgan Leguen, Julie Gratieux, Fernando Pico, Haja Rakotoharinandrasana, Philippe Tassan, Roxanna Poll, Sylvie Marinier, Norbert Nighoghossian, Roberto Riva, Francis Turjman, Tae-Hee Cho, Laura Mechtouff, Anne Claire Lukaszewicz, Frédéric Philippeau, Serkan Cakmak, Karine Blanc-Lasserre, Anne-Evelyne Vallet, Gaultier Marnat, Florent Gariel, Xavier Barreau, Jérôme Berge, Patrice Menegon, Igor Sibon, Ludovic Lucas, Stéphane Olindo, Pauline Renou, Sharmila Sagnier, Mathilde Poli, Sabrina Debruxelles, François Rouanet, Thomas Tourdias, Jean-Sebastien Liegey, Pierre Briau, Nicolas Pangon, Romain Bourcier, Lili Detraz, Benjamin Daumas-Duport, Pierre-Louis Alexandre, Monica Roy, Cédric Lenoble, Hubert Desal, Benoît Guillon, Solène de Gaalon, Cécile Preterre, Benjamin Gory, Serge Bracard, René Anxionnat, Marc Braun, Anne-Laure Derelle, Romain Tonnelet, Liang Liao, François Zhu, Emmanuelle Schmitt, Sophie Planel, Sébastien Richard, Lisa Humbertjean, Gioia Mione, Jean-Christophe Lacour, Nolwenn Riou-Comte, Gérard Audibert, Marcela Voicu, Ionel Alb, Marie Reitter, Madalina Brezeanu, Agnès Masson, Adriana Tabarna, Iona Podar, Francisco Macian-montoro, Suzanna Saleme, Charbel Mounayer, Aymeric Rouchaud, Vincent Costalat, Caroline Arquizan, Cyril Dargazanli, Grégory Gascou, Pierre-Henri Lefèvre, Imad Derraz, Carlos Riquelme, Nicolas Gaillard, Isabelle Mourand, Lucas Corti, Federico Cagnazzo, Adrien ter Schiphorst, Eugene Francois, Stéphane Vannier, Jean-christophe Ferre, Helene Raoult, Thomas Ronziere, Maria Lassale, Christophe Paya, Jean-Yves Gauvrit, Clément Tracol, Sophie Langnier-Lemercier, Yves Samson, Charlotte Rosso, Anne Leger, Sandrine Deltour, Frederic Clarencon, Eimad Shotar, Laurent Spelle, Christian Denier, Olivier Chassin, Vanessa Chalumeau, Jildaz Caroff, Laura Venditti, Olivier Naggara, Wagih Ben Hassen, Grégoire Boulouis, Christine Rodriguez-Régent, Denis Trystram, Basile Kerleroux, Guillaume Turc, Valérie Domigo, Catherine Lamy, Julia Birchenall, Clothilde Isabel, François Lun, Alain Viguier, Christophe Cognard, Anne Christine Januel, Jean-Marc Olivot, Nicolas Raposo, Fabrice Bonneville, Jean François Albucher, Lionel Calviere, Jean Darcourt, Philippe Tall, Guillaume Bellanger, Louis Fontaine, Emmanuel Touze, Charlotte Barbier, Romain Schneckenburger, Marion Boulanger, Julien Cogez, Sophie Guettier, Serge Timsit, Jean-christophe Gentric, Julien Ognard, Francois Mathias Merrien, Ozlem Ozkul Wermester, Evelyne Massardier, Chrysanthi Papagiannaki, Frédéric Bourdain, Patricia Bernady, Laurent Lagoarde-Segot, Hélène Cailliez, Louis Veunac, David Higue, Valérie Wolff, Raoul Pop, Rémi Beaujeux, Mihoc Dan-Sorin, Monica Manisor, Anthony Le Bras, Sarah Evain, Arnaud Le Guen, Sebastian Richter, Regis Hubrecht, Stéphanie Demasles, Bruno Barroso, Denis Sablot, Geoffroy Farouil, Maxime Tardieu, Philippe Smadja, Sabine Aptel, Ian Seiler
Journal of Neuroradiology. 2023-02-01; 50(1): 59-64
DOI: 10.1016/j.neurad.2022.03.006


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Ducroux C(1), Derex L(2), Nourredine M(3), Haesebaert J(3), Buisson M(4), Alesefir W(1), Boisseau W(5), Daneault N(6), Deschaintre Y(6), Diestro JDB(5), Eker O(7), Eneling J(5), Gioia LC(6), Iancu D(5), Jacquin G(6), Odier C(6), Stapf C(6), Raymond J(5), Roy D(5), Weill A(5), Lapergue B(8), Poppe AY(9); ETIS (Endovascular Treatment in Ischemic Stroke) Investigators.

Collaborators: Piotin M, Blanc R, Escalard HRS, Desilles JP, Delvoye F, Smajda
S, Maier B, Hebert S, Mazighi M, Obadia M, Sabben C, Seners P, Raynouard I,
Corabianu O, de Broucker T, Manchon E, Taylor G, Ben Maacha M, Thion LA, Lecler
A, Savatovsky J, Wang A, Evrard S, Tchikviladze M, Ajili N, Lapergue B,
Weisenburger-Lile D, Gorza L, Buard G, Coskun O, Consoli A, Di Maria F, Rodesh
G, Zimatore S, Leguen M, Gratieux J, Pico F, Rakotoharinandrasana H, Tassan P,
Poll R, Marinier S, Nighoghossian N, Riva R, Eker O, Turjman F, Derex L, Cho TH,
Mechtouff L, Lukaszewicz AC, Philippeau F, Cakmak S, Blanc-Lasserre K, Vallet
AE, Marnat G, Gariel F, Barreau X, Berge J, Menegon P, Sibon I, Lucas L, Olindo
S, Renou P, Sagnier S, Poli M, Debruxelles S, Rouanet F, Tourdias T, Liegey JS,
Briau P, Pangon N, Bourcier R, Detraz L, Daumas-Duport B, Alexandre PL, Roy M,
Lenoble C, Desal H, Guillon B, de Gaalon S, Preterre C, Gory B, Bracard S,
Anxionnat R, Braun M, Derelle AL, Tonnelet R, Liao L, Zhu F, Schmitt E, Planel
S, Richard S, Humbertjean L, Mione G, Lacour JC, Riou-Comte N, Audibert G, Voicu
M, Alb I, Reitter M, Brezeanu M, Masson A, Tabarna A, Podar I, Macian-Montoro F,
Saleme S, Mounayer C, Rouchaud A, Costalat V, Arquizan C, Dargazanli C, Gascou
G, Lefèvre PH, Derraz I, Riquelme C, Gaillard N, Mourand I, Corti L, Cagnazzo F,
Ter Schiphorst A, Francois E, Vannier S, Ferre JC, Raoult H, Ronziere T, Lassale
M, Paya C, Gauvrit JY, Tracol C, Langnier-Lemercier S, Samson Y, Rosso C, Leger
A, Deltour S, Clarencon F, Shotar E, Spelle L, Denier C, Chassin O, Chalumeau V,
Caroff J, Chassin O, Venditti L, Naggara O, Hassen WB, Boulouis G,
Rodriguez-Régent C, Trystram D, Kerleroux B, Turc G, Domigo V, Lamy C,
Birchenall J, Isabel C, Lun F, Viguier A, Cognard C, Januel AC, Olivot JM,
Raposo N, Bonneville F, Albucher JF, Calviere L, Darcourt J, Tall P, Bellanger
G, Fontaine L, Touze E, Barbier C, Schneckenburger R, Boulanger M, Cogez J,
Guettier S, Timsit S, Gentric JC, Ognard J, Merrien FM, Wermester OO, Massardier
E, Papagiannaki C, Bourdain F, Bernady P, Lagoarde-Segot L, Cailliez H, Veunac
L, Higue D, Wolff V, Pop R, Beaujeux R, Dan-Sorin M, Manisor M, Le Bras A, Evain
S, Le Guen A, Richter S, Hubrecht R, Demasles S, Barroso B, Sablot D, Farouil G,
Tardieu M, Smadja P, Aptel S, Seiler I.

Author information:
(1)Department of Neurosciences, Faculté de médecine, Université de Montréal,
Montréal, QC, Canada; Department of Medicine (Neurology), Centre Hospitalier de
l’Université de Montréal, 900 rue St-Denis, Bureau R04-758, Montréal, QC H2X
0A9, Canada.
(2)Department of Neurology, Stroke Center, Neurological Hospital, Hospices
Civils de Lyon, University of Lyon, France; Research on Healthcare Performance
(RESHAPE), INSERM U1290, University Claude Bernard Lyon 1, Lyon, France.
(3)Department of Research and Epidemiology, Pôle de Santé Publique, Hospices
Civils de Lyon, Lyon, France; Department of pharmaco-toxicology, Hospices Civils
de Lyon, Lyon, France.
(4)Clinical Investigation Center, INSERM 1407, Louis Pradel Hospital, Hospices
Civils de Lyon, Lyon, France.
(5)Department of Radiology, Centre Hospitalier de l’Université de Montréal,
Montréal, QC, Canada.
(6)Department of Neurosciences, Faculté de médecine, Université de Montréal,
Montréal, QC, Canada; Department of Medicine (Neurology), Centre Hospitalier de
l’Université de Montréal, 900 rue St-Denis, Bureau R04-758, Montréal, QC H2X
0A9, Canada; Neurovascular Group, Neurosciences Axis, Centre de Recherche du
Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada.
(7)Department of Neuroradiology, Neurological Hospital, Hospices Civils de Lyon,
Lyon, France.
(8)Department of Neurology, Foch Hospital, Suresnes, France.
(9)Department of Neurosciences, Faculté de médecine, Université de Montréal,
Montréal, QC, Canada; Department of Medicine (Neurology), Centre Hospitalier de
l’Université de Montréal, 900 rue St-Denis, Bureau R04-758, Montréal, QC H2X
0A9, Canada; Neurovascular Group, Neurosciences Axis, Centre de Recherche du
Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada.
Electronic address: .

BACKGROUND: Patients with pre-stroke disability, defined as a modified Rankin
Scale (mRS) ≥3, were excluded from most trials of endovascular thrombectomy
(EVT) for acute stroke. We sought to evaluate the prognostic factors associated
with favorable outcome in stroke patients with known disability undergoing EVT,
and the impact of successful reperfusion.
METHODS: Consecutive acute stroke patients with pre-stroke disability,
undergoing EVT, were retrospectively collected between 2016 to 2019 from a
Canadian cohort and a multicenter French cohort (Endovascular Treatment in
Ischemic Stroke registry-ETIS). Favorable outcome was defined as an mRS equal to
pre-stroke mRS. Patients achieving successful reperfusion (defined as a modified
Thrombolysis in Cerebral Infarction score of 2b/3) were compared with patients
without successful reperfusion to determine if successful EVT was associated
with better functional outcomes.
RESULTS: Among 6220 patients treated with EVT, 280 (4.5%) patients with a
pre-stroke mRS ≥3 were included. Sixty-one patients (21.8%) had a favorable
outcome and 146 (52.1%) died at 3 months. Patients with successful reperfusion
had a higher proportion of favorable 90-day mRS (27.6% versus 19.6%, p = 0.025)
and a lower mortality (48.3% versus 69.6%, p = 0.008) than patients without
successful reperfusion. After adjusting for baseline prognostic factors,
successful reperfusion defined by TICI ≥2b was associated with favorable
functional outcome (OR 3.16 CI95% [1.11-11.5]; p 0.048).
CONCLUSION: In patients with pre-stroke disability, successful reperfusion is
associated with a greater proportion of favorable outcome and lower mortality.

Copyright © 2022 Elsevier Masson SAS. All rights reserved.

DOI: 10.1016/j.neurad.2022.03.006
PMID: 35341899 [Indexed for MEDLINE]

Conflict of interest statement: Declaration of Competing Interest Authors
declare no conflicts of interests.

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