Collateral status reperfusion and outcomes after endovascular therapy: insight from the Endovascular Treatment in Ischemic Stroke (ETIS) Registry.

Brain Ischemia / diagnostic imaging Collateral Circulation Endovascular Procedures Humans Ischemic Stroke Prospective Studies Registries Reperfusion Stroke / diagnostic imaging Thrombectomy Treatment Outcome

blood flow stroke thrombectomy

Journal

Journal of neurointerventional surgery

ISSN: 1759-8486

Titre abrégé: J Neurointerv Surg

Pays: England

ID NLM: 101517079

Informations de publication

Date de publication:
Jun 2022

Historique:

received: 21 03 2021

accepted: 31 05 2021

pubmed: 19 6 2021

medline: 18 5 2022

entrez: 18 6 2021

Statut: ppublish

Résumé

Studies have suggested that collateral status modifies the effect of successful reperfusion on functional outcome after endovascular therapy (EVT). We aimed to assess the association between collateral status and EVT outcomes and to investigate whether collateral status modified the effect of successful reperfusion on EVT outcomes. We used data from the ongoing, prospective, multicenter Endovascular Treatment in Ischemic Stroke (ETIS) Registry. Collaterals were graded according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) guidelines. Patients were divided into two groups based on angiographic collateral status: poor (grade 0-2) versus good (grade 3-4) collaterals. Among 2020 patients included in the study, 959 (47%) had good collaterals. Good collaterals were associated with favorable outcome (90-day modified Rankin Scale (mRS) 0-2) (OR 1.5, 95% CI 1.19 to 1.88). Probability of good outcome decreased with increased time from onset to reperfusion in both good and poor collateral groups. Successful reperfusion was associated with higher odds of favorable outcome in good collaterals (OR 6.01, 95% CI 3.27 to 11.04) and poor collaterals (OR 5.65, 95% CI 3.32 to 9.63) with no significant interaction. Similarly, successful reperfusion was associated with higher odds of excellent outcome (90-day mRS 0-1) and lower odds of mortality in both groups with no significant interaction. The benefit of successful reperfusion decreased with time from onset in both groups, but the curve was steeper in the poor collateral group. Collateral status predicted functional outcome after EVT. However, collateral status on the pretreatment angiogram did not decrease the clinical benefit of successful reperfusion.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

We used data from the ongoing, prospective, multicenter Endovascular Treatment in Ischemic Stroke (ETIS) Registry. Collaterals were graded according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) guidelines. Patients were divided into two groups based on angiographic collateral status: poor (grade 0-2) versus good (grade 3-4) collaterals.

RESULTS RESULTS

Among 2020 patients included in the study, 959 (47%) had good collaterals. Good collaterals were associated with favorable outcome (90-day modified Rankin Scale (mRS) 0-2) (OR 1.5, 95% CI 1.19 to 1.88). Probability of good outcome decreased with increased time from onset to reperfusion in both good and poor collateral groups. Successful reperfusion was associated with higher odds of favorable outcome in good collaterals (OR 6.01, 95% CI 3.27 to 11.04) and poor collaterals (OR 5.65, 95% CI 3.32 to 9.63) with no significant interaction. Similarly, successful reperfusion was associated with higher odds of excellent outcome (90-day mRS 0-1) and lower odds of mortality in both groups with no significant interaction. The benefit of successful reperfusion decreased with time from onset in both groups, but the curve was steeper in the poor collateral group.

CONCLUSIONS CONCLUSIONS

Collateral status predicted functional outcome after EVT. However, collateral status on the pretreatment angiogram did not decrease the clinical benefit of successful reperfusion.

Identifiants

DOI: 10.1136/neurintsurg-2021-017553 PMID: 34140288

pubmed: 34140288

pii: neurintsurg-2021-017553

doi: 10.1136/neurintsurg-2021-017553

doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

551-557

Investigateurs

Michel Piotin (M)

Raphael Blanc (R)

Hocine Redjem (H)

Simon Escalard (S)

Jean-Philippe Dessilles (JP)

François Delvoye (F)

Stanislas Smajda (S)

Benjamin Maier (B)

Hebert Solène (H)

Mikael Mazighi (M)

Mikael Obadia (M)

Candice Sabben (C)

Pierre Seners (P)

Igor Raynouard (I)

Ovide Corabianu (O)

Thomas de Broucker (T)

Eric Manchon (E)

Guillaume Taylor (G)

Malek Ben Maacha (MB)

Laurie-Anne Thion (LA)

Augustin Lecler (A)

Julien Savatovsky (J)

Adrien Wang (A)

Serge Evrard (S)

Maya Tchikviladze (M)

Nadia Ajili (N)

Bertrand Lapergue (B)

David Weisenburger-Lile (D)

Lucas Gorza (L)

Géraldine Buard (G)

Oguzhan Coskun (O)

Arturo Consoli (A)

Federico Di Maria (FD)

Georges Rodesch (G)

Sergio Zimatore (S)

Morgan Leguen (M)

Julie Gratieux (J)

Fernando Pico (F)

Haja Rakotoharinandrasana (H)

Philippe Tassan (P)

Roxanna Poll (R)

Sylvie Marinier (S)

Gaultier Marnat (G)

Florent Gariel (F)

Xavier Barreau (X)

Jérôme Berge (J)

Patrice Menegon (P)

Igor Sibon (I)

Ludovic Lucas (L)

Stéphane Olindo (S)

Pauline Renou (P)

Sharmila Sagnier (S)

Mathilde Poli (M)

Sabrina Debruxelles (S)

François Rouanet (F)

Thomas Tourdias (T)

Jean-Sebastien Liegey (JS)

Pierre Briau (P)

Nicolas Pangon (N)

Romain Bourcier (R)

Lili Detraz (L)

Benjamin Daumas-Duport (B)

Pierre-Louis Alexandre (PL)

Monica Roy (M)

Cédric Lenoble (C)

Hubert Desal (H)

Benoît Guillon (B)

Solène de Gaalon (S)

Cécile Preterre (C)

Benjamin Gory (B)

Serge Bracard (S)

René Anxionnat (R)

Marc Braun (M)

Anne-Laure Derelle (AL)

Tonnelet Romain (T)

Liang Liao (L)

François Zhu (F)

Emmanuelle Schmitt (E)

Sophie Planel (S)

Sébastien Richard (S)

Lisa Humbertjean (L)

Gioia Mione (G)

Jean-Christophe Lacour (JC)

Gérard Audibert (G)

Marcela Voicu (M)

Lionel Alb (L)

Marie Reitter (M)

Madalina Brezeanu (M)

Agnès Masson (A)

Adriana Tabarna (A)

Iona Podar (I)

Pauline Bourst (P)

Sarah Guy (S)

Fatiha Bechiri (F)

Francisco Macian-Montoro (F)

Suzanna Saleme (S)

Charbel Mounayer (C)

Aymeric Rouchaud (A)

Laetitia Gimenez (L)

Alexandre Cosnard (A)

Vincent Costalat (V)

Caroline Arquizan (C)

Cyril Dargazanli (C)

Grégory Gascou (G)

Pierre-Henri Lefèvre (PH)

Imad Derraz (I)

Carlos Riquelme (C)

Nicolas Gaillard (N)

Isabelle Mourand (I)

Lucas Corti (L)

Federico Cagnazzo (F)

Adrien Ter Schiphorst (AT)

Francois Eugene (F)

Stéphane Vannier (S)

Jean-Christophe Ferre (JC)

Hélène Raoult (H)

Thomas Ronziere (T)

Maria Lassale (M)

Christophe Paya (C)

Jean-Yves Gauvrit (JY)

Clément Tracol (C)

Sophie Langnier-Lemercier (S)

Axelle Maurice (A)

Sabrina Cochennec (S)

Mélanie Pinault (M)

Frédéric Clarençon (F)

Eimad Shotar (E)

Nader Sourour (N)

Stéphanie Lenck (S)

Kévin Premat (K)

Yves Samson (Y)

Anne Léger (A)

Sophie Crozier (S)

Flore Baronnet (F)

Sonia Alamowitch (S)

Laure Bottin (L)

Mathon Yger (M)

Vincent Degos (V)

Laurent Spelle (L)

Christian Denier (C)

Olivier Chassin (O)

Vanessa Chalumeau (V)

Jildaz Caroff (J)

Olivier Chassin (O)

Laura Venditti (L)

Mariana Sarov (M)

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Olivier Naggara (O)

Wagih Ben Hassen (WB)

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Guillaume Turc (G)

Valérie Domigo (V)

Catherine Lamy (C)

Julia Birchenall (J)

Clothilde Isabel (C)

François Lun (F)

Alain Viguier (A)

Christophe Cognard (C)

Anne-Christine Januel (AC)

Jean-Marc Olivot (JM)

Louis Fontaine (L)

Nicolas Raposo (N)

Fabrice Bonneville (F)

Jean-François Albucher (JF)

Lionel Calviere (L)

Jean Darcourt (J)

Guillaume Bellanger (G)

Philippe Tall (P)

Emmanuel Touze (E)

Charlotte Barbier (C)

Romain Schneckenburger (R)

Marion Boulanger (M)

Julien Cogez (J)

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Maxime Gauberti (M)

Serge Timsit (S)

Jean-Christophe Gentric (JC)

Julien Ognard (J)

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Ozlem Wermester (O)

Evelyne Massardier (E)

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Aude Triquenot (A)

Margeaux Lefebvre (M)

Frédéric Bourdain (F)

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Julien Pottecher (J)

Alain Meyer (A)

Thiên-Nga Chamaraux-Tran (TN)

Anthony Le Bras (AL)

Sarah Evain (S)

Arnaud Le Guen (AL)

Informations de copyright

Déclaration de conflit d'intérêts

Competing interests: None declared.