[en] [en] BACKGROUND: It is unknown whether collateral status modifies the effect of pretreatment intravenous thrombolysis (IVT) on the outcomes of patients with large vessel occlusions treated with endovascular therapy (EVT). We aimed to assess whether collateral status modifies the effect of IVT on the outcomes of EVT in clinical practice.
METHODS: We used data from the ongoing prospective multicentric Endovascular Treatment in Ischemic Stroke (ETIS) Registry in France. Patients with anterior circulation proximal large vessel occlusions treated with EVT within 6 hours of symptom onset were enrolled. Patients were divided into two groups based on pretreatment with IVT. The two groups were matched based on baseline characteristics. We tested the interaction between collateral status and IVT in unadjusted and adjusted models.
RESULTS: A total of 1589 patients were enrolled in the study, of whom 55% received IVT. Using a propensity score matching method, 724 no IVT patients were matched to 549 IVT patients. In propensity score weighted analysis, IVT was associated with higher odds of early neurological improvement (OR 1.74; 95% CI 1.33 to 2.26), favorable functional outcome (OR 1.66; 95% CI 1.23 to 2.24), excellent functional outcome (OR 2.04; 95% CI 1.47 to 2.83), and successful reperfusion (OR 2.18; 95% CI 1.51 to 3.16). IVT was not associated with mortality or hemorrhagic complications. There was no interaction between collateral status and IVT association with any of the outcomes.
CONCLUSIONS: Collateral status does not modify the effect of pretreatment IVT on the efficacy and safety outcomes of EVT.
Disciplines :
Neurology
Author, co-author :
Anadani, Mohammad ; Neurosurgery, Medical University of South Carolina - College of Medicine, Charleston, South Carolina, USA anadani@musc.edu
Januel, Anne-Christine; Neuroradiology, University Hospital of Purpan, Toulouse, France
Finitsis, Stephanos; Neuroradiolology, University General Hospital of Thessaloniki AHEPA, Thessaoniki, Greece
Clarençon, Frédéric ; Interventional Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France
Richard, Sébastien ; Neurology Stroke Unit, University Hospital Centre Nancy, Nancy, France
Marnat, Gaultier ; Interventional and Diagnostic Neuroradiology, Bordeaux University Hospital, Bordeaux, France
Bourcier, Romain; CHU de Nantes, Nantes, France
Sibon, Igor; CHU de Bordeaux, Bordeaux, France
Dargazanli, Cyril; Department of Neuroradiology, University Hospital Centre Montpellier, Montpellier, France
Arquizan, Caroline; Neurology, CHRU Gui de Chauliac, Montpellier, France
Blanc, Raphael; Interventional Neuroradiology, Fondation Rothschild, Paris, France
Lapergue, Bertrand; Neurology, Stroke Unit, Hospital Foch, Suresnes, France
Consoli, Arturo; Hopital Foch, Suresnes, France
Eugene, Francois ; Radiologie, CHU Rennes, Rennes, France
Vannier, Stephane; Department of Neurology, CHU Rennes, Rennes, France
Caroff, Jildaz ; Department of Interventional Neuroradiology - NEURI Brain Vascular Center, Bicêtre Hospital, APHP, Le Kremlin Bicêtre, France
Denier, Christian; Neurology, Hôpital Bicetre, Le Kremlin-Bicetre, Île-de-France, France
Boulanger, Marion; Neurology, CHU Caen, Caen, France
Gauberti, Maxime; Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France
Rouchaud, Aymeric ; Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France ; Department of Neurology, CHU Limoges, Limoges, France
Macian Montoro, Francisco; Department of Neurology, CHU Limoges, Limoges, France
Rosso, Charlotte; Urgences Cérébro-Vasculaires, Pitié-Salpétrière Hospital, Paris, France
Ben Hassen, Wagih; Interventional Neuroradiology, Saint Anne Hospital Centre, Paris, France ; INSERM U1166, Paris, France
Turc, Guillaume ; Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France
Ozkul-Wermester, Ozlem; Department of Neurology, CHU Rouen, Rouen, France
Papagiannaki, Chrysanthi ; Interventional Neuroradiology, CHU Rouen, Rouen, France
Albucher, Jean François; Neurology, University Hospital Centre Toulouse, Toulouse, France
Le Bras, Anthony ; Department of Radiology, CH Bretagne Atlantique, Vannes, France ; CHU Rennes Service de Radiologie et d'Imagerie Médicale, Rennes, France
Evain, Sarah; Department of Neurology, Centre Hospitalier Bretagne Atlantique, Vannes, France
Wolff, Valerie; Stroke Unit, Strasbourg University Hospitals, Strasbourg, France
Pop, Raoul ; Interventional Neuroradiology, University Hospitals Strasbourg, Strasbourg, France ; Interventional Radiology, Institut de Chirurgie Guidée par l'Image, Strasbourg, France
Timsit, Serge; Department of Neurology, CHU Brest, Brest, France
Gentric, Jean-Christophe ; Neuroradiology, CHRU de Brest, Brest, France
Bourdain, Frederic; Neurology, Centre Hospitalier de la Cote Basque, Bayonne, Aquitaine, France
Veunac, Louis; Department of Radiology and Interventional Neuroradiology, CHU de Bordeaux, Bordeaux, France
de Havenon, Adam ; Department of Neurology, University of Utah, Salt Lake City, Utah, USA
Liebeskind, David S; Neurology, UCLA, Los Angeles, California, USA
Maier, Benjamin; Interventional Neuroradiology, Adolphe de Rothschild Ophthalmological Foundation, Paris, France
Gory, Benjamin; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France
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