Combined Technique for Internal Carotid Artery Terminus or Middle Cerebral Artery Occlusions in the ASTER2 Trial-Reference-Cited by-同舟云学术

Combined Technique for Internal Carotid Artery Terminus or Middle Cerebral Artery Occlusions in the ASTER2 Trial

Published:2024-02 Issue:2 Volume:55 Page:376-384
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Sgreccia Alessandro¹^ORCID,Desilles Jean-Philippe²^ORCID,Costalat Vincent³,Dargazanli Cyril³^ORCID,Bourcier Romain⁴^ORCID,Tessier Guillaume⁴,Rouchaud Aymeric⁵^ORCID,Saleme Suzana⁵^ORCID,Spelle Laurent⁶^ORCID,Caroff Jildaz⁶^ORCID,Marnat Gaultier⁷^ORCID,Barreau Xavier⁷^ORCID,Clarençon Frédéric⁸^ORCID,Shotar Eimad⁸^ORCID,Eugene François⁹,Houdart Emmanuel¹⁰^ORCID,Gory Benjamin¹¹^ORCID,Zhu François¹¹^ORCID,Labreuche Julien¹²^ORCID,Piotin Michel²^ORCID,Lapergue Bertrand¹^ORCID,Consoli Arturo¹^ORCID,Blanc Raphael,Redjem Hocine,Ciccio Gabriele,Smajda Stanislas,Mazighi Mikael,Fahed Robert,Rodesch Georges,Coskun Oguzhan,Di Maria Federico,Bourdain Frédéric,Decroix Jean Pierre,Wang Adrien,Tchikviladze Maya,Evrard Serge,Turjman Francis,Labeyrie Paul Emile,Riva Roberto,Mounayer Charbel,Saleme Suzana,Costalat Vincent,Bonafé Alain,Eker Omer,Gascou Grégory,Bracard Serge,Tonnelet Romain,Derelle Anne Laure,Anxionnat René,Desal Hubert,Daumas-Duport B.,Berge Jérome,Barreau Xavier,Djemmane Lynda,Labreuche Julien,Duhamel. Alain

Affiliation:

1. Diagnostic and Interventional Neuroradiology, Foch Hospital, Suresnes, France (A.S., B.L., A.C.).

2. Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France (J.-P.D., M.P.).

3. Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, France (V.C., C.D.).

4. Department of Diagnostic and Interventional Neuroradiology, University Hospital of Nantes, France (R.B., G.T.).

5. Interventional Neuroradiology Department, Centre Hospitalier Universitaire Limoges, France (A.R., S.S.).

6. Interventional Neuroradiology Department, Kremlin Bicêtre Hospital, France (L.S., J.C.).

7. Interventional Neuroradiology Department, Centre Hospitalier Régional Universitaire Bordeaux, France (G.M., X.B.).

8. Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France (F.C., E.S.).

9. Department of Neuroradiology, Centre Hospitalier Universitaire de Rennes, France (F.E.).

10. Department of Neuroradiology, Lariboisière Hospital, Paris, France (E.H.).

11. Department of Neuroradiology, Centre Hospitalier Universitaire de Rennes, France (B.G., F.Z.).

12. Department of Biostatistics, Centre Hospitalier Universitaire Lille, Equipe d’accueil 2694 Santé Publique: Epidémiologie et Qualité des Soins, University Lille, France (J.L.).

Abstract

BACKGROUND: The aim of this study was to report the results of a subgroup analysis of the ASTER2 trial (Effect of Thrombectomy With Combined Contact Aspiration and Stent Retriever vs Stent Retriever Alone on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion) comparing the safety and efficacy of the combined technique (CoT) and stent retriever as a first-line approach in internal carotid artery (ICA) terminus±M1-middle cerebral artery (M1-MCA) and isolated M1-MCA occlusions. METHODS: Patients enrolled in the ASTER2 trial with ICA terminus±M1-MCA and isolated M1-MCA occlusions were included in this subgroup analysis. The effect of first-line CoT versus stent retriever according to the occlusion site was assessed on angiographic (first-pass effect, expanded Treatment in Cerebral Infarction score ≥2b50, and expanded Treatment in Cerebral Infarction score ≥2c grades at the end of the first-line strategy and at the end of the procedure) and clinicoradiological outcomes (24-hour National Institutes of Health Stroke Scale, ECASS-III [European Cooperative Acute Stroke Study] grades, and 3-month modified Rankin Scale). RESULTS: Three hundred sixty-two patients were included in the postsubgroup analysis according to the occlusion site: 299 were treated for isolated M1-MCA occlusion (150 with first-line CoT) and 63 were treated for ICA terminus±M1-MCA occlusion (30 with first-line CoT). Expanded Treatment in Cerebral Infarction score ≥2b50 (odds ratio, 11.83 [95% CI, 2.32–60.12]) and expanded Treatment in Cerebral Infarction score ≥2c (odds ratio, 4.09 [95% CI, 1.39–11.94]) were significantly higher in first-line CoT compared with first-line stent retriever in patients with ICA terminus±M1-MCA occlusion but not in patients with isolated M1-MCA. CONCLUSIONS: First-line CoT was associated with higher reperfusion grades in patients with ICA terminus±M1-MCA at the end of the procedure. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03290885.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference27 articles.

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