Accéder directement au contenu Accéder directement à la navigation
Article dans une revue

Susceptibility vessel sign in the aster trial: higher recanalization rate and more favourable clinical outcome after first line stent retriever compared to contact aspiration

Abstract : Background and Purpose In the Aspiration vs. Stent Retriever for Successful Revascularization (ASTER) trial, which evaluated contact aspiration (CA) versus stent retriever (SR) use as first-line technique, the impact of the susceptibility vessel sign (SVS) on magnetic resonance imaging (MRI) was studied to determine its influence on trial results. Methods We included patients having undergone CA or SR for M1 or M2 occlusions, who were screened by MRI with T2* gradient recalled echo. Occlusions were classified as SVS (+) or SVS (-) in each randomization arm. Modified thrombolysis in cerebral infarction (mTICI) 2b, 2c, or 3 revascularization rates were recorded and clinical outcomes assessed by the overall distribution of modified Rankin scale (mRS) at 90 days. Results Among the 202 patients included, 143 patients were SVS (+) (70.8%; 95% confidence interval [CI], 64.5% to 77.1%). Overall, there was no difference in angiographic and clinical outcomes according to SVS status. However, compared to SR, CA achieved a lower mTICI 2c/3 rate in SVS (+) patients (risk ratio [RR] for CA vs. SR, 0.60; 95% CI, 0.51 to 0.71) but not in SVS (-) (RR, 1.11; 95% CI, 0.69 to 1.77; P for interaction=0.018). A significant heterogeneity in favor of superiority of first-line SR strategy in SVS (+) patients was also found regarding the overall mRS distribution (common odds ratio for CA vs. SR, 0.40 vs. 1.32; 95% CI, 0.21 to 0.74 in SVS (+) vs. 95% CI, 0.51 to 3.35 in SVS (-); P for interaction=0.038). Conclusions As a first line strategy, SR achieved higher recanalization rates and a more favourable clinical outcome at 3 months compared to CA when MRI shows SVS within the thrombus.
Type de document :
Article dans une revue
Liste complète des métadonnées

Littérature citée [38 références]  Voir  Masquer  Télécharger

https://hal.univ-lille.fr/hal-02612406
Contributeur : Lilloa Université de Lille <>
Soumis le : mardi 19 mai 2020 - 10:24:53
Dernière modification le : jeudi 11 juin 2020 - 04:19:30

Fichier

jos-2018-00192.pdf
Fichiers éditeurs autorisés sur une archive ouverte

Licence


Distributed under a Creative Commons Paternité - Pas d'utilisation commerciale 4.0 International License

Identifiants

Citation

Romain Bourcier, Mikael Mazighi, Julien Labreuche, Robert Fahed, Raphael Blanc, et al.. Susceptibility vessel sign in the aster trial: higher recanalization rate and more favourable clinical outcome after first line stent retriever compared to contact aspiration. Journal of Stroke, Korean Stroke Society, 2018, 20 (2), pp.268-276. ⟨10.5853/jos.2018.00192.e1⟩. ⟨hal-02612406⟩

Partager

Métriques

Consultations de la notice

8

Téléchargements de fichiers

18