Small vessel disease and collaterals in ischemic stroke patients treated with thrombectomy
2022
Forestier, G. | Agbonon, R. | Bricout, N. | Benhassen, W. | Turc, G. | Bretzner, M. | Pasi, M. | Benzakoun, J. | Seners, P. | Personnic, T. | Legrand, L. | Trystram, D. | Rodriguez-Regent, C. | Charidimou, A. | Rost, N. S. | Bracard, S. | Clarençon, F. | Eker, O. F. | Nighoghossian, N. | Cordonnier, C. | Oppenheim, C. | Naggara, O. | Henon, H. | Boulouis, G. | Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité) | Hôpital Dupuytren [CHU Limoges] | Groupe hospitalier universitaire Paris psychiatrie & neurosciences [Paris] (GHU Paris Psychiatrie et Neurosciences) | Lille Neurosciences & Cognition - U 1172 (LilNCog) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [CHU Lille] (CHRU Lille) | Massachusetts General Hospital [Boston] | Harvard Medical School [Boston] (HMS) | Université Paris Cité (UPCité) | Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy) | Imagerie Adaptative Diagnostique et Interventionnelle (IADI) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL) | CHU Pitié-Salpêtrière [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU) | Sorbonne Université - Faculté de Médecine (SU FM) ; Sorbonne Université (SU) | Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL] ; Hospices Civils de Lyon (HCL) | Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN) ; Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon | Centre Hospitalier Sainte Anne [Paris] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
International audience
Show more [+] Less [-]English. BACKGROUND AND PURPOSE: To determine the influence of the cerebral small vessel disease (SVD) burden on collateral recruitment in patients treated with mechanical thrombectomy (MT) for anterior circulation acute ischemic stroke (AIS). METHODS: Patients with AIS due to large vessel occlusion (LVO) from the Thrombectomie des Artères Cérébrales (THRACE) trial and prospective cohorts from 2 academic comprehensive stroke centers treated with MT were pooled and retrospectively analyzed. Collaterals' adequacy was assessed using the American Society of Interventional and Therapeutic Radiology/Society of Interventional Radiology (ASITN/SIR) score on initial digital subtraction angiography and dichotomized as good (3,4) versus poor (0-2) collaterals. The SVD burden was rated with the global SVD score on MRI. Multivariable logistic regression analyses were used to determine relationships between SVD and ASITN/SIR scores. RESULTS: A total of 312 participants were included (53.2% males, mean age 67.8 ± 14.9 years). Two hundred and seven patients had poor collaterals (66.4%), and 133 (42.6%) presented with any SVD signature. In multivariable analysis, patients demonstrated worse leptomeningeal collaterality with increasing SVD burden before and after adjustment for SVD risk factors (adjusted odds ratio [aOR] 0.69; 95%CI [0.52-0.89] and aOR 0.66; 95%CI [0.5-0.88], respectively). Using individual SVD markers, poor collaterals were significantly associated with the presence of lacunes (aOR 0.40, 95% CI [0.20-0.79]). CONCLUSION: Our study provides evidence that in patients with AIS due to LVO treated with MT, the burden of SVD assessed by pre-treatment MRI is associated with poorer recruitment of leptomeningeal collaterals.
Show more [+] Less [-]AGROVOC Keywords
Bibliographic information
This bibliographic record has been provided by Institut national de la recherche agronomique
