Thrombectomy complications in large vessel occlusions: Incidence, predictors, and clinical impact in the ETIS registry
- Type de publi. : Article dans une revue
- Date de publi. : 28/10/2021
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Auteurs :
Emmanuel Happi NgankouBenjamin GoryGaultier MarnatSébastien RichardRomain BourcierIgor SibonCyril DargazanliCaroline ArquizanBenjamin MaïerRaphaël BlancBertrand LapergueArturo ConsoliStéphane VannierLaurent SpelleChristian DenierMarion BoulangerMaxime GaubertiSuzana SalemeFrancisco MacianFrédéric ClarençonCharlotte RossoOlivier NaggaraGeorgios TsivgoulisOzlem Ozkul-WermesterChrysanthi PapagiannakiAlain ViguierChristophe CognardAnthony LebrasSarah EvainValérie WolffRaoul PopSerge TimsitJean Christophe GentricFrédéric BourdainLouis VeunacFrançois EugèneStephanos Nikolaos FinitsisMichel P. PiotinHocine RedjemSimon EscalardJean Philippe DessillesFrançois DelvoyeStanislas SmajdaHebert SolèneMikaël MazighiMikael ObadiaCandice SabbenPierre SenersIgor RaynouardOvide CorabianuThomas de BrouckerEric ManchonGuillaume TaylorMalek Ben MaachaLaurie Anne ThionAugustin LeclerJulien SavatovsjyFoch HospitalAdrien WangSerge EvrardMaya TchikviladzeNadia AjiliDavid WeisenburgerlileLucas GorzaGéraldine BuardOguzhan CoskunFederico Di MariaGeorges RodeshSergio ZimatoreMorgan LeguenJulie GratieuxFernando PicoHaja RakotoharinandrasanaPhilippe TassanRoxanna PollSylvie MarinierFlorent GarielXavier BarreauJérôme BergePatrice MenegonLudovic LucasStéphane OlindoPauline RenouSharmila SagnierMathilde PoliSabrina DebruxellesFrançois RouanetThomas TourdiasJean Sebastien LiegeyPierre BriauNicolas PangonLili DetrazBenjamin Daumas-DuportPierre Louis AlexandreMonica RoyCédric LenobleHubert Armand DesalBenoît GuillonSolène de GaalonCécile PreterreSerge BracardRené AnxionnatMarc BraunAnne Laure DerelleTonnelet RomainLiang LiaoFrançois ZhuEmmanuelle SchmittSophie PlanelLisa HumbertjeanGioia MioneJean Christophe LacourNolwenn Riou-ComteGérard AudibertMarcela VoicuLionel AlbMarie ReitterMadalina BrezeanuAgnès MassonAdriana TabarnaIona PodarSarah GuyFatiha BechiriPauline BourstFrancisco Macian-MontoroSuzanna SalemeCharbel MounayerAymeric RouchaudLaetitia GimenezAlexandre CosnardVincent CostalatGrégory GascouPierre Henri LefèvreImad DerrazCarlos RiquelmeNicolas GaillardIsabelle MourandLucas CortiFederico CagnazzoAdrien ter SchiphorstJean-Christophe FerréHélène RaoultThomas RonziereMaria LassaleChristophe PayaJean Yves GauvritClément TracolSophie Langnier-LemercierAxelle MauriceSabrina CochennecMélanie PinaultEimad ShotarNader Antoine SourourStéphanie LenckKévin PrematYves Samson Anne LégerSophie CrozierFlore BaronnetSonia AlamowitchLaure BottinMarion YgerVincent DegosOlivier ChassinVanessa ChalumeauJildaz CaroffLaura VendittiMariana SarovNicolas LegrisOlivier NaggaraWagih Ben HassenGrégoire BoulouisChristine Rodriguez-RégentDenis TrystramBasile KerlerouxValérie DomigoCatherine LamyJulia BirchenallClothilde IsabelFrançois LunChristophe CognardAnne Christine JanuelJean Marc OlivotLouis FontaineNicolas RaposoFabrice BonnevilleJean-François AlbucherLionel CalviereJean DarcourtGuillaume BellangerPhilippe TallEmmanuel TouzéCharlotte BarbierRomain SchneckenburgerJulien CogezSophie GuettierJulien OgnardFrançois Mathias MerrienOzlem Ozku WermesterEvelyne Guégan MassardierAude Bagan TriquenotMargeaux LefebvrePatricia BernadyLaurent Lagoarde-SegotHélène CailliezDavid HigueVéronique QuenardelleValérie LauerRoxana GheocaIrène Nora Pierre-PaulRemy BeaujeuxDan MihocMonica ManisorJulien PottecherAlain MeyerThiên-Nga Chamaraux-TranAnthony Le BrasArnaud Le Guen
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Organismes :
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Imagerie Adaptative Diagnostique et Interventionnelle
Centre Hospitalier Universitaire de Bordeaux
Service de neurologie [CHRU Nancy]
Centre d'investigation clinique plurithématique Pierre Drouin [Nancy]
Défaillance Cardiovasculaire Aiguë et Chronique
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
Centre Hospitalier Universitaire de Bordeaux
Neuroradiologie [Hôpital Gui de Chauliac]
Hôpital Gui de Chauliac [CHU Montpellier]
CHU Rothschild [AP-HP]
CHU Rothschild [AP-HP]
Service Neuroradiologie diagnostique et interventionnelle [Hôpital Foch]
UFR Sciences de la santé Simone Veil
Service Neuroradiologie diagnostique et interventionnelle [Hôpital Foch]
UFR Sciences de la santé Simone Veil
Service de Neurologie [CHU Rennes]
Service de Neuroradiologie [CHU de Bicêtre]
Service de neurologie [Le Kremlin Bicêtre]
Service de Neurologie [CHU Caen]
Départment de Neuroradiologie [CHU Caen]
Service de Neuroradiologie interventionnelle [CHU Limoges]
Service de Neurologie [CHU Limoges]
CHU Pitié-Salpêtrière [AP-HP]
CHU Pitié-Salpêtrière [AP-HP]
Service de Neurologie [CH Saint-Anne]
Service de Neurologie [CH Saint-Anne]
Service de neurologie [Rouen]
Département de Neuroradiologie [CHU Rouen]
Département Neurologie [CHU Toulouse]
Service Neuroradiologie Diagnostique et Thérapeutique [CHU Toulouse]
Service de radiologie [Vannes]
Service de radiologie [Vannes]
Service de Neurologie [Strasbourg]
Département de Neuroradiologie [Strasbourg]
Service de Neurologie [Brest]
Service de Neuroradiologie [Brest]
Neurologie - Côte Basque
Neurologie - Côte Basque
Service de Neurologie [CHU Rennes]
Aristotle University of Thessaloniki
Neuroimagerie: méthodes et applications
- Publié dans Stroke le 31/10/2020
Résumé : BACKGROUND AND PURPOSE: Procedural complications in thrombectomy for large vessel occlusions of the anterior circulation are not well described. We investigated the incidence, risk factors, and clinical implications of thrombectomy complications in daily clinical practice. METHODS: We used data from the ongoing prospective multicenter observational Endovascular Treatment in Ischemic Stroke Registry in France. The present study is a retrospective analysis of 4029 stroke patients with anterior large vessel occlusions treated with thrombectomy between January 2015 and May 2020 in 18 centers. We systematically collected procedural data, incidence of embolic complications, perforations and dissections, clinical outcome at 90 days, and hemorrhagic complications. RESULTS: Procedural complications occurred in 7.99% (95% CI, 7.17%–8.87%), and embolus to a new territory (ENT) was the most frequent (5.2%). Predictors of ENTs were terminal carotid/tandem occlusion (odds ratio [OR], 5 [95% CI, 2.03–12.31]; P<0.001) and an increased total number of passes (OR, 1.22 [95% CI, 1.05–1.41]; P=0.006). ENTs were associated to worse clinical outcomes (90-day modified Rankin Scale score, 0–2; adjusted OR, 0.4 [95% CI, 0.25–0.63]; P<0.001), increased mortality (adjusted OR, 1.74 [95% CI, 1.2–2.53]; P<0.001), and symptomatic intracerebral hemorrhage (adjusted OR, 1.87 [95% CI, 1.15–3.03]; P=0.011). Perforations occurred in 1.69% (95% CI, 1.31%–2.13%). Predictors of perforations were terminal carotid/tandem occlusions (39.7% versus 27.6%; P=0.028). 40.7% of patients died at 90 days, and the overall rate of poor outcome was 74.6% in case of perforation. Dissections occurred in 1.46% (95% CI, 1.11%–1.88%) and were more common in younger patients (median age, 64.2 versus 70.2 years; P=0.002). Dissections did not affect the clinical outcome at 90 days. Besides dissection, complications were independent of the thrombectomy technique. CONCLUSIONS: Thrombectomy complication rate is not negligible, and ENTs were the most frequent. ENTs and perforations were associated with disability and mortality, and terminal carotid/tandem occlusions were a risk factor.
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