Safety of Emergent Intracranial Stenting after Thrombolysis: A Multicenter Matched Analysis
Rattachement africain : it, fr, cn, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
ABSTRACT BACKGROUND AND PURPOSE: In patients with acute large vessel occlusion (LVO) of the MCA and underlying intracranial artery stenosis (ICAS), rescue stenting (RS) has been associated with better angiographic outcomes and higher rates of functional independence compared to mechanical thrombectomy (MT) alone. However, uncertainty exists regarding safety of RS in patients at higher risk for intracranial bleeding. The primary aim of this retrospective multicenter study was to compare safety outcomes between patients with acute ICAS-LVO of the MCA who underwent MT and RS with or without prior intravenous thrombolysis (IVT). Efficacy outcomes were assessed as a secondary aim. METHODS: We screened the prospective databases of 26 stroke centers across Europe, the United States, and China for consecutive patients with acute MCA ICAS-LVO who received RS. Patients were divided into two groups based on prior administration of IVT: IVT/RS and no-IVT/RS. Propensity score matching (PSM), based on a set of covariates that also included peri-procedural antiplatelet therapies, was used to estimate the effect of IVT treatment. Primary safety outcomes were the occurrence of symptomatic intracranial hemorrhage (sICH) and 90-day mortality. RESULTS: After PSM, 52 pairs of patients were available for analysis. No significant differences were observed between the two groups regarding rates of sICH (11.5% in IVT/RS group vs. 9.6% in no-IVT/RS group, OR 1.2, 95% CI 0.4-4.3, p = 0.75) and 90-day mortality (14.3% in the IVT/RS group vs. 11.7% in the no-IVT/RS group, OR 1.3, 95% CI 0.4-4.2, p = 0.71). There were also no significant differences in the occurrence of parenchymal hemorrhage types 1 and 2, successful recanalization rates and 90-day functional outcome. CONCLUSIONS: The safety of RS in ICAS-LVO is not significantly affected by prior IVT administration. Furthermore, IVT does not result in improved recanalization and clinical outcome. These findings should be interpreted with caution and require validation through future randomized controlled studies. ABBREVIATIONS: MT＝ mechanical thrombectomy; LVO＝ large vessel occlusion; ICAS = intracranial artery stenosis; RS = rescue stenting; IVT = intravenous thrombolysis; sICH = symptomatic intracranial Hemorrhage; PH = parenchymal hematoma; SD = standard deviation; IQR = interquartile range; PSM = propensity score matching; SMD = standardized mean difference; OTG = onset-to-groin; GPI = glycoprotein IIb/IIIa inhibitors.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Safety of Emergent Intracranial Stenting after Thrombolysis: A Multicenter Matched Analysis
- Date Crossref
- 10/07/2025
- Éditeur
- American Society of Neuroradiology (ASNR)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Agostino Gemelli University Polyclinic pays non établi dans la noticeÉtablissement de santé
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Université Paris-Est Créteil pays non établi dans la noticeUniversité ou école supérieure
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Hôpitaux Universitaires Henri-Mondor pays non établi dans la noticeÉtablissement de santé
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Hôpital Foch Department of Diagnostic and Therapeutic Neuroradiology (A.C. pays non établi dans la noticeÉtablissement de santé
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University of Science and Technology of China pays non établi dans la noticeUniversité ou école supérieure
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Wannan Medical College Department of Neurology (X.H.) pays non établi dans la noticeÉtablissement de santé
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First Affiliated Hospital of Wannan Medical College pays non établi dans la noticeÉtablissement de santé
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NYU Langone Health Departments of Neurosurgery and Radiology (C.C. pays non établi dans la noticeÉtablissement de santé
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Boston Medical Center Department of Radiology and Neurology (M.A. pays non établi dans la noticeÉtablissement de santé
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Azienda Ospedaliero-Universitaria Careggi pays non établi dans la noticeÉtablissement de santé
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Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda pays non établi dans la noticeÉtablissement de santé
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Presidio Ospedaliero pays non établi dans la noticeÉtablissement de santé
Agostino Gemelli University Polyclinic, Université Paris-Est Créteil et Hôpitaux Universitaires Henri-Mondor, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.