Outcome of patients with large vessel occlusion stroke after first admission in telestroke spoke versus comprehensive stroke center

被引：11

作者：

Kaminsky, Anne-Laure ^{[1
]}

Mione, Gioia ^{[1
]}

Omorou, Yacoubou ^{[2
]}

Humbertjean, Lisa ^{[1
]}

Bonnerot, Mathieu ^{[1
]}

Lacour, Jean Christophe ^{[1
]}

Riou-Comte, Nolwenn ^{[1
]}

Anadani, Mohammad ^{[3
,4
]}

Gory, Benjamin ^{[5
]}

Richard, Sebastien ^{[1
,6
]}

机构：

[1] Univ Hosp Nancy, Stroke Unit, Dept Neurol, Nancy, France

[2] CHU Nancy, Ctr Invest Clin CIC 1433, Epidemiol Clin, Nancy, Lorraine, France

[3] Washington Univ, Sch Med St Louis, St Louis, MO 63110 USA

[4] Med Univ South Carolina, Coll Med, Neurol, Charleston, SC 29425 USA

[5] Univ Hosp Nancy, INSERM U1254, Dept Diagnost & Therapeut Neuroradiol, Nancy, France

[6] CHRU, Ctr Invest Clin Plurithemat CIC 1433, Nancy, Lorraine, France

来源：

JOURNAL OF NEUROINTERVENTIONAL SURGERY | 2020年 / 12卷 / 08期

关键词：

stroke; thrombectomy; thrombolysis; INTRAVENOUS THROMBOLYSIS; MECHANICAL THROMBECTOMY; INTRAARTERIAL TREATMENT; ENDOVASCULAR TREATMENT; ISCHEMIC-STROKE; ALTEPLASE; TRIAL; RECANALIZATION; THRACE;

D O I：

10.1136/neurintsurg-2019-015342

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

Introduction While telestroke allows early intravenous thrombolysis (IVT) for ischemic strokes in spoke centers, mechanical thrombectomy (MT) for large vessel occlusion (LVO) is mainly performed at comprehensive stroke centers (CSCs). We aimed to compare 3 month outcome in patients with LVO after admission to a spoke center using telestroke compared with first CSC admission in our large regional stroke network, irrespective of final treatment decision. Methods All consecutive LVO patients who were admitted to one of six spoke centers or to the regional CSC within 6 hours of symptom onset were prospectively included from September 1, 2015 to August 31, 2017. All patients admitted to spoke centers were assessed on site with cerebral and vessel imaging. Primary outcome was 3 month favorable outcome (modified Rankin Scale score of 0-2). Results Distances between spoke centers and CSC ranged from 36 to 77 miles. Among 207 included patients, 132 (63.8%) were first admitted to CSCs and 75 (36.2%) to spoke centers. IVT was administered more in spoke centers (81.3% vs 53.8%, p<0.0001) while MT was performed less (26.7% vs 49.2%, p=0.001) and with a longer time from onset (303 vs 200 min, p<0.0001). No difference was found in 3 month favorable outcome between spoke centers compared with CSCs (32.0% and 35.1%, respectively; OR=0.68; 95% CI 0.42 to 1.10; p=0.12). Conclusions Despite different distribution of reperfusion therapies for LVO patients managed by telemedicine, we could not demonstrate a difference in functional outcome according to admission location in a large area with long distances between centers.

引用

页码：753 / 757

页数：6

共 30 条

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← 1 2 3 →

共 30 条

[1] CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].

ADAMS, HP ;

BENDIXEN, BH ;

KAPPELLE, LJ ;

BILLER, J ;

LOVE, BB ;

GORDON, DL ;

MARSH, EE ;

KASE, CS ;

WOLF, PA ;

BABIKIAN, VL ;

LICATAGEHR, EE ;

ALLEN, N ;

BRASS, LM ;

FAYAD, PB ;

PAVALKIS, FJ ;

WEINBERGER, JM ;

TUHRIM, S ;

RUDOLPH, SH ;

HOROWITZ, DR ;

BITTON, A ;

MOHR, JP ;

SACCO, RL ;

CLAVIJO, M ;

ROSENBAUM, DM ;

SPARR, SA ;

KATZ, P ;

KLONOWSKI, E ;

CULEBRAS, A ;

CAREY, G ;

MARTIR, NI ;

FICARRA, C ;

HOGAN, EL ;

CARTER, T ;

GURECKI, P ;

MUNTZ, BK ;

RAMIREZLASSEPAS, M ;

TULLOCH, JW ;

QUINONES, MR ;

MENDEZ, M ;

ZHANG, SM ;

ALA, T ;

JOHNSTON, KC ;

ANDERSON, DC ;

TARREL, RM ;

NANCE, MA ;

BUDLIE, SR ;

DIERICH, M ;

HELGASON, CM ;

HIER, DB ;

SHAPIRO, RA .

STROKE, 1993, 24 (01) :35-41

[2] Acute endovascular treatment delivery to ischemic stroke patients transferred within a telestroke network: a retrospective observational study [J].

Barlinn, Jessica ;

Gerber, Johannes ;

Barlinn, Kristian ;

Pallesen, Lars-Peder ;

Siepmann, Timo ;

Zerna, Charlotte ;

Wojciechowski, Claudia ;

Puetz, Volker ;

von Kummer, Ruediger ;

Reichmann, Heinz ;

Linn, Jennifer ;

Bodechtel, Ulf .

INTERNATIONAL JOURNAL OF STROKE, 2017, 12 (05) :502-509

[3] A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke [J].

Berkhemer, O. A. ;

Fransen, P. S. S. ;

Beumer, D. ;

van den Berg, L. A. ;

Lingsma, H. F. ;

Yoo, A. J. ;

Schonewille, W. J. ;

Vos, J. A. ;

Nederkoorn, P. J. ;

Wermer, M. J. H. ;

van Walderveen, M. A. A. ;

Staals, J. ;

Hofmeijer, J. ;

van Oostayen, J. A. ;

Nijeholt, G. J. Lycklama A. ;

Boiten, J. ;

Brouwer, P. A. ;

Emmer, B. J. ;

de Bruijn, S. F. ;

van Dijk, L. C. ;

Kappelle, L. J. ;

Lo, R. H. ;

Van Dijk, E. J. ;

de Vries, J. ;

de Kort, P. L. M. ;

van Rooij, W. J. J. ;

van den Berg, J. S. P. ;

van Hasselt, B. A. A. M. ;

Aerden, L. A. M. ;

Dallinga, R. J. ;

Visser, M. C. ;

Bot, J. C. J. ;

Vroomen, P. C. ;

Eshghi, O. ;

Schreuder, T. H. C. M. L. ;

Heijboer, R. J. J. ;

Keizer, K. ;

Tielbeek, A. V. ;

den Hertog, H. M. ;

Gerrits, D. G. ;

van den Berg-Vos, R. M. ;

Karas, G. B. ;

Steyerberg, E. W. ;

Flach, H. Z. ;

Marquering, H. A. ;

Sprengers, M. E. S. ;

Jenniskens, S. F. M. ;

Beenen, L. F. M. ;

van den Berg, R. ;

Koudstaal, P. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (01) :11-20

[4] Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial [J].

Bracard, Serge ;

Ducrocq, Xavier ;

Mas, Jean Louis ;

Soudant, Marc ;

Oppenheim, Catherine ;

Moulin, Thieriy ;

Guillemin, Francis .

LANCET NEUROLOGY, 2016, 15 (11) :1138-1147

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Campbell, B. C. V. ;

Mitchell, P. J. ;

Churilov, L. ;

Yassi, N. ;

Kleinig, T. J. ;

Dowling, R. J. ;

Yan, B. ;

Bush, S. J. ;

Dewey, H. M. ;

Thijs, V. ;

Scroop, R. ;

Simpson, M. ;

Brooks, M. ;

Asadi, H. ;

Wu, T. Y. ;

Shah, D. G. ;

Wijeratne, T. ;

Ang, T. ;

Miteff, F. ;

Levi, C. R. ;

Rodrigues, E. ;

Zhao, H. ;

Salvaris, P. ;

Garcia-Esperon, C. ;

Bailey, P. ;

Rice, H. ;

de Villiers, L. ;

Brown, H. ;

Redmond, K. ;

Leggett, D. ;

Fink, J. N. ;

Collecutt, W. ;

Wong, A. A. ;

Muller, C. ;

Coulthard, A. ;

Mitchell, K. ;

Clouston, J. ;

Mahady, K. ;

Field, D. ;

Ma, H. ;

Phan, T. G. ;

Chong, W. ;

Chandra, R. V. ;

Slater, L. -A. ;

Krause, M. ;

Harrington, T. J. ;

Faulder, K. C. ;

Steinfort, B. S. ;

Bladin, C. F. ;

Sharma, G. .

NEW ENGLAND JOURNAL OF MEDICINE, 2018, 378 (17) :1573-1582

[6] Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection [J].

Campbell, B. C. V. ;

Mitchell, P. J. ;

Kleinig, T. J. ;

Dewey, H. M. ;

Churilov, L. ;

Yassi, N. ;

Yan, B. ;

Dowling, R. J. ;

Parsons, M. W. ;

Oxley, T. J. ;

Wu, T. Y. ;

Brooks, M. ;

Simpson, M. A. ;

Miteff, F. ;

Levi, C. R. ;

Krause, M. ;

Harrington, T. J. ;

Faulder, K. C. ;

Steinfort, B. S. ;

Priglinger, M. ;

Ang, T. ;

Scroop, R. ;

Barber, P. A. ;

McGuinness, B. ;

Wijeratne, T. ;

Phan, T. G. ;

Chong, W. ;

Chandra, R. V. ;

Bladin, C. F. ;

Badve, M. ;

Rice, H. ;

de Villiers, L. ;

Ma, H. ;

Desmond, P. M. ;

Donnan, G. A. ;

Davis, S. M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1009-1018

Campbell, Bruce C. V. ;

Majoie, Charles B. L. M. ;

Albers, Gregory W. ;

Menon, Bijoy K. ;

Yassi, Nawaf ;

Sharma, Gagan ;

van Zwam, Wim H. ;

van Oostenbrugge, Robert J. ;

Demchuk, Andrew M. ;

Guillemin, Francis ;

White, Philip ;

Davalos, Antoni ;

van der Lugt, Aad ;

Butcher, Kenneth S. ;

Cherifi, Aboubaker ;

Marquering, Henk A. ;

Cloud, Geoffrey ;

Macho Fernandez, Juan M. ;

Madigan, Jeremy ;

Oppenheim, Catherine ;

Donnan, Geoffrey A. ;

Roos, Yvo B. W. E. M. ;

Shankar, Jai ;

Lingsma, Hester ;

Bonafe, Alain ;

Raoult, Helene ;

Hernandez-Perez, Maria ;

Bharatha, Aditya ;

Jahan, Reza ;

Jansen, Olav ;

Richard, Sebastien ;

Levy, Elad I. ;

Berkhemer, Olvert A. ;

Soudant, Marc ;

Aja, Lucia ;

Davis, Stephen M. ;

Krings, Timo ;

Tisserand, Marie ;

San Roman, Luis ;

Tomasello, Alejandro ;

Beumer, Debbie ;

Brown, Scott ;

Liebeskind, David S. ;

Bracard, Serge ;

Muir, Keith W. ;

Dippel, Diederik W. J. ;

Goyal, Mayank ;

Saver, Jeffrey L. ;

Jovin, Tudor G. ;

Hill, Michael D. .

LANCET NEUROLOGY, 2019, 18 (01) :46-55

[8] Alteplase Reduces Downstream Microvascular Thrombosis and Improves the Benefit of Large Artery Recanalization in Stroke [J].

Desilles, Jean-Philippe ;

Loyau, Stephane ;

Syvannarath, Varouna ;

Gonzalez-Valcarcel, Jaime ;

Cantier, Marie ;

Louedec, Liliane ;

Lapergue, Bertrand ;

Amarenco, Pierre ;

Ajzenberg, Nadine ;

Jandrot-Perrus, Martine ;

Michel, Jean-Baptiste ;

Ho-Tin-Noe, Benoit ;

Mazighi, Mikael .

STROKE, 2015, 46 (11) :3241-3248

Froehler, Michael T. ;

Saver, Jeffrey L. ;

Zaidat, Osama O. ;

Jahan, Reza ;

Aziz-Sultan, Mohammad Ali ;

Klucznik, Richard P. ;

Haussen, Diogo C. ;

Hellinger, Frank R., Jr. ;

Yavagal, Dileep R. ;

Yao, Tom L. ;

Liebeskind, David S. ;

Jadhav, Ashutosh P. ;

Gupta, Rishi ;

Hassan, Ameer E. ;

Martin, Coleman O. ;

Bozorgchami, Hormozd ;

Kaushal, Ritesh ;

Nogueira, Raul G. ;

Gandhi, Ravi H. ;

Peterson, Eric C. ;

Dashti, Shervin R. ;

Given, Curtis A., II ;

Mehta, Brijesh P. ;

Deshmukh, Vivek ;

Starkman, Sidney ;

Linfante, Italo ;

McPherson, Scott H. ;

Kvamme, Peter ;

Grobelny, Thomas J. ;

Hussain, Muhammad S. ;

Thacker, Ike ;

Vora, Nirav ;

Chen, Peng Roc ;

Monteith, Stephen J. ;

Ecker, Robert D. ;

Schirmer, Clemens M. ;

Sauvageau, Eric ;

Abou-Chebl, Alex ;

Derdeyn, Colin P. ;

Maidan, Lucian ;

Badruddin, Aamir ;

Siddiqui, Adnan H. ;

Dumont, Travis M. ;

Alhajeri, Abdulnasser ;

Taqi, M. Asif ;

Asi, Khaled ;

Carpenter, Jeffrey ;

Boulos, Alan ;

Jindal, Gaurav ;

Puri, Ajit S. .

CIRCULATION, 2017, 136 (24) :2311-2321

Gautheron, Vincent ;

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Raoult, Helene ;

Soize, Sebastien ;

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Bourcier, Romain ;

Richard, Sebastien ;

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Oppenheim, Catherine .

STROKE, 2018, 49 (03) :750-753

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