Reperfusion treatment in acute ischaemic stroke due to cervical and cerebral artery dissection: results of a Spanish national multicentre study.

Tratamiento de reperfusión en el ictus isquémico agudo por disección arterial cervicocerebral: descripción de los resultados de un estudio nacional multicéntrico.
Disección Dissection Fibrinolysis Fibrinólisis Ictus Reperfusion Reperfusión Stroke Thrombectomy Trombectomía

Journal

Neurologia
ISSN: 2173-5808
Titre abrégé: Neurologia (Engl Ed)
Pays: Spain
ID NLM: 101778590

Informations de publication

Date de publication:
21 Dec 2020
Historique:
received: 21 07 2020
revised: 14 09 2020
accepted: 05 10 2020
entrez: 28 12 2020
pubmed: 29 12 2020
medline: 29 12 2020
Statut: aheadofprint

Résumé

Ischaemic stroke (IS) due to cervical and cerebral artery dissection (CAD) is a rare entity, and few data are available on the use of such reperfusion therapies as intravenous fibrinolysis and mechanical thrombectomy in these patients. We analysed the use of these treatments in patients with IS due to CAD and compared them against patients receiving reperfusion treatment for IS of other aetiologies. We conducted an observational, retrospective, multicentre study of patients with IS due to CAD recorded in the National Stroke Registry of the Spanish Society of Neurology during the period 2011-2019. Comparative analyses were performed between: a) patients with CAD treated and not treated with reperfusion therapies and b) patients treated with reperfusion for IS due to CAD and patients treated with reperfusion for IS due to other causes. Epidemiological data, stroke variables, and outcomes at discharge and at 3 months were included in the analysis. The study included 21,037 patients with IS: 223 (1%) had IS due to CAD, of whom 68 (30%) received reperfusion treatment. Reperfusion treatments were used less frequently in cases of vertebral artery dissection and more frequently in patients with carotid artery occlusion. Compared to patients with IS due to other causes, patients with CAD were younger, more frequently underwent mechanical thrombectomy, and less frequently received intravenous fibrinolysis. Rates of haemorrhagic complications, mortality, and independence at 3 months were similar in both groups. Reperfusion therapy is frequently used in patients with IS due to CAD. The outcomes of these patients demonstrate the efficacy and safety of reperfusion treatments, and are comparable to the outcomes of patients with IS due to other aetiologies.

Identifiants

pubmed: 33358059
pii: S0213-4853(20)30430-8
doi: 10.1016/j.nrl.2020.10.016
pii:
doi:

Types de publication

Journal Article

Langues

eng spa

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2020 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Auteurs

D Campo-Caballero (D)

Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España. Electronic address: davidcampo19@gmail.com.

P de la Riva (P)

Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España.

A de Arce (A)

Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España.

M Martínez-Zabaleta (M)

Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España.

J Rodríguez-Antigüedad (J)

Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España.

J Ekiza (J)

Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España.

P Iruzubieta (P)

Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España.

F Purroy (F)

Servicio de Neurología, Hospital Arnau de Vilanova de Lleida, Lleida, España.

B Fuentes (B)

Servicio de Neurología, Hospital Universitario La Paz, Madrid, España.

M de Lera Alfonso (M)

Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.

J Krupinski (J)

Servicio de Neurología, Hospital Universitari Mútua de Terrassa, Terrassa, España.

J J Mengual Chirife (JJ)

Servicio de Neurología, Hospital Moisés Broggi, Sant Joan Despí, España.

E Palomeras (E)

Servicio de Neurología, Hospital de Mataró, Mataró, España.

D Guisado-Alonso (D)

Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.

M Rodríguez-Yáñez (M)

Servicio de Neurología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España.

X Ustrell (X)

Servicio de Neurología, Hospital Universitari Joan XXIII, Tarragona, España.

J Tejada García (J)

Servicio de Neurología, Hospital de León, León, España.

A de Felipe Mimbrera (A)

Servicio de Neurología, Hospital Ramón y Cajal, Madrid, España.

M Paré-Curell (M)

Servicio de Neurología, Hospital Universitari Germans Trias i Pujol, Badalona, España.

J Tembl (J)

Servicio de Neurología, Hospital Universitari i Politécnic La Fe, Valencia, España.

S Cajaraville (S)

Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña, A Coruña, España.

M Garcés (M)

Servicio de Neurología, Hospital Clínico Lozano Blesa, Zaragoza, España.

J Serena (J)

Servicio de Neurología, Hospital Universitari Dr. Josep Trueta, Girona, España.

Classifications MeSH