Efficacy and safety of endovascular treatment in acute ischemic stroke due to cervical artery dissection: A 15-year consecutive case series

被引：20

作者：

Bernardo, Francisco ^{[1
,2
]}

Nannoni, Stefania ^{[1
]}

Strambo, Davide ^{[1
]}

Puccinelli, Francesco ^{[3
]}

Saliou, Guillaume ^{[3
]}

Michel, Patrik ^{[1
]}

Sirimarco, Gaia ^{[1
]}

机构：

[1] Lausanne Univ Hosp, Neurol Serv, Stroke Ctr, Rue Bugnon 46, CH-1011 Lausanne, Switzerland

[2] Hosp Prof Doutor Fernando Fonseca, Dept Neurol, Amadora, Portugal

[3] Lausanne Univ Hosp, Dept Diagnost & Intervent Radiol, Intervent Neuroradiol Unit, Lausanne, Switzerland

来源：

INTERNATIONAL JOURNAL OF STROKE | 2019年 / 14卷 / 04期

关键词：

Cervical artery dissection; endovascular treatment; acute ischemic stroke; intravenous thrombolysis; INTRAVENOUS THROMBOLYSIS; MECHANICAL THROMBECTOMY; INTRAARTERIAL TREATMENT; RECANALIZATION; MANAGEMENT; ALTEPLASE; THERAPY; TRIAL; CARE;

D O I：

10.1177/1747493018823161

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Limited observational data are available on endovascular treatment in acute ischemic stroke due to cervical artery dissection. Three studies comparing endovascular treatment with standard medical therapy or intravenous thrombolysis in cervical artery dissection-related acute ischemic stroke did not demonstrate superiority of endovascular treatment. Efficacy and the choice of endovascular treatment technique in this setting remain to be established. Aims:To assess the potential efficacy and safety of endovascular treatment compared to intravenous thrombolysis alone or to no revascularization treatment in our center. Methods: We selected all consecutive patients with cervical artery dissection-related acute ischemic stroke and intracranial occlusion from the Acute STroke Registry and Analysis of Lausanne between 2003 and 2017. We compared clinical and neuroimaging data of patients treated by endovascular treatment versus patients receiving intravenous thrombolysis or patients without revascularization treatment. Safety analysis included symptomatic intracranial hemorrhage, major radiological hemorrhages (parenchymal hematoma 1, parenchymal hematoma 2, and subarachnoid hemorrhage) and mortality within seven days. We assessed favorable clinical outcome (modified Rankin Scale 0-2) at three months using a binary logistic regression model. Results: Of the 109 patients included, 24 had endovascular treatment, 38 received intravenous thrombolysis alone, and 47 had no revascularization treatment. Endovascular treatment patients had a higher rate of recanalization at 24 h. Major radiological hemorrhages occurred more often in endovascular treatment patients (all with bridging therapy) than in patients without revascularization treatment (p = 0.026), with no differences in symptomatic intracranial hemorrhage or mortality within seven days. Favorable clinical outcome at three months did not differ between groups (endovascular treatment versus intravenous thrombolysis p = 0.407; endovascular treatment versus no revascularization treatment p = 0.580). Conclusions: In this single-center cohort of cervical artery dissection-related acute ischemic stroke with intracranial occlusion, endovascular treatment with prior intravenous thrombolysis may increase the risk of major radiological but not symptomatic intracranial hemorrhage. Despite the lack of clear superiority in our cohort, endovascular treatment should currently not be withheld in these patients.

引用

页码：381 / 389

页数：9

共 33 条

[1] Stent-Assisted endovascular thrombolysis versus intravenous thrombolysis in internal carotid artery dissection with tandem internal carotid and middle cerebral artery occlusion [J].

Baumgartner, Ralf W. ;

Georgiadis, Dimitrios ;

Nedeltchev, Krassen ;

Schroth, Gerhard ;

Sarikaya, Hakan ;

Arnold, Marcel .

STROKE, 2008, 39 (02) :E27-E28

[2] 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

[3] 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

[4] 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

[5] Emergency endovascular revascularization of tandem occlusions: Internal carotid artery dissection and intracranial large artery embolism [J].

Cohen, Jose E. ;

Leker, Ronen R. ;

Eichel, Roni ;

Gomori, Moshe ;

Itshayek, Eyal .

JOURNAL OF CLINICAL NEUROSCIENCE, 2016, 28 :157-161

[6] Differential features of carotid and vertebral artery dissections The CADISP Study [J].

Debette, S. ;

Grond-Ginsbach, C. ;

Bodenant, M. ;

Kloss, M. ;

Engelter, S. ;

Metso, T. ;

Pezzini, A. ;

Brandt, T. ;

Caso, V. ;

Touze, E. ;

Metso, A. ;

Canaple, S. ;

Abboud, S. ;

Giacalone, G. ;

Lyrer, P. ;

del Zotto, E. ;

Giroud, M. ;

Samson, Y. ;

Dallongeville, J. ;

Tatlisumak, T. ;

Leys, D. ;

Martin, J. J. .

NEUROLOGY, 2011, 77 (12) :1174-1181

[7] Association of Vascular Risk Factors With Cervical Artery Dissection and Ischemic Stroke in Young Adults [J].

Debette, Stephanie ;

Metso, Tiina ;

Pezzini, Alessandro ;

Abboud, Sherine ;

Metso, Antti ;

Leys, Didier ;

Bersano, Anna ;

Louillet, Fabien ;

Caso, Valeria ;

Lamy, Chantal ;

Medeiros, Elisabeth ;

Samson, Yves ;

Grond-Ginsbach, Caspar ;

Engelter, Stefan T. ;

Thijs, Vincent ;

Beretta, Simone ;

Bejot, Yannick ;

Sessa, Maria ;

Muiesan, Maria Lorenza ;

Amouyel, Philippe ;

Castellano, Maurizio ;

Arveiler, Dominique ;

Tatlisumak, Turgut ;

Dallongeville, Jean .

CIRCULATION, 2011, 123 (14) :1537-U106

[8] Thrombolysis in Cervical Artery Dissection - Data from the Cervical Artery Dissection and Ischaemic Stroke Patients (CADISP) database [J].

Engelter, S. T. ;

Dallongeville, J. ;

Kloss, M. ;

Metso, T. M. ;

Leys, D. ;

Brandt, T. ;

Samson, Y. ;

Caso, V. ;

Pezzini, A. ;

Sessa, M. ;

Beretta, S. ;

Debette, S. ;

Grond-Ginsbach, C. ;

Metso, A. J. ;

Thijs, V. ;

Lamy, C. ;

Medeiros, E. ;

Martin, J. J. ;

Bersano, A. ;

Tatlisumak, T. ;

Touze, E. ;

Lyrer, P. A. .

EUROPEAN JOURNAL OF NEUROLOGY, 2012, 19 (09) :1199-1206

[9] Diagnosis and Treatment of Cervical Artery Dissection [J].

Engelter, Stefan T. ;

Traenka, Christopher ;

Von Hessling, Alexander ;

Lyrer, Philippe A. .

NEUROLOGIC CLINICS, 2015, 33 (02) :421-+

[10] Intravenous Thrombolysis in Stroke Attributable to Cervical Artery Dissection [J].

Engelter, Stefan T. ;

Rutgers, Matthieu P. ;

Hatz, Florian ;

Georgiadis, Dimitrios ;

Fluri, Felix ;

Sekoranja, Lucka ;

Schwegler, Guido ;

Mueller, Felix ;

Weder, Bruno ;

Sarikaya, Hakan ;

Luethy, Regina ;

Arnold, Marcel ;

Nedeltchev, Krassen ;

Reichhart, Marc ;

Mattle, Heinrich P. ;

Tettenborn, Barbara ;

Hungerbuehler, Hansjoerg J. ;

Sztajzel, Roman ;

Baumgartner, Ralf W. ;

Michel, Patrik ;

Lyrer, Philippe A. .

STROKE, 2009, 40 (12) :3772-3776

← 1 2 3 4 →