Manuel Cappellari, Giovanni Pracucci, Valentina Saia, Nicolò Mandruzzato, Francesco Valletta, Fabrizio Sallustio, Ilaria Casetta, Enrico Fainardi, Valerio Da Ros, Marina Diomedi, Francesco Capasso, Patrizia Nencini, Stefano Vallone, Guido Bigliardi, Agostino Tessitore, Paolino La Spina, Sandra Bracco, Rossana Tassi, Mauro Bergui, Paolo Cerrato, Maria Ruggiero, Marco Longoni, Lucio Castellan, Laura Malfatto, Andrea Saletti, Alessandro De Vito, Roberto Menozzi, Umberto Scoditti, Luigi Simonetti, Andrea Zini, Elvis Lafe, Anna Cavallini, Guido Andrea Lazzarotti, Nicola Giannini, Andrea Boghi, Andrea Naldi, Daniele Romano, Rosa Napoletano, Alessio Comai, Enrica Franchini, Nicola Cavasin, Adriana Critelli, Andrea Giorgianni, Lucia Princiotta Cariddi, Vittorio Semeraro, Giovanni Boero, Domenico Sergio Zimatore, Marco Petruzzellis, Francesco Biraschi, Ettore Nicolini, Alessandro Pedicelli, Giovanni Frisullo, Andrea Calzoni, Tiziana Tassinari, Ivan Gallesio, Federica Sepe, Pietro Filauri, Simona Sacco, Emilio Lozupone, Annalisa Rizzo, Michele Besana, Alessia Giossi, Marco Pavia, Paolo Invernizzi, Pietro Amistà, Monia Russo, Francesco Florio, Vincenzo Inchingolo, Marco Filizzolo, Marina Mannino, Salvatore Mangiafico, Danilo Toni
{"title":"后循环与前循环串联闭塞缺血性脑卒中患者的血栓切除术。","authors":"Manuel Cappellari, Giovanni Pracucci, Valentina Saia, Nicolò Mandruzzato, Francesco Valletta, Fabrizio Sallustio, Ilaria Casetta, Enrico Fainardi, Valerio Da Ros, Marina Diomedi, Francesco Capasso, Patrizia Nencini, Stefano Vallone, Guido Bigliardi, Agostino Tessitore, Paolino La Spina, Sandra Bracco, Rossana Tassi, Mauro Bergui, Paolo Cerrato, Maria Ruggiero, Marco Longoni, Lucio Castellan, Laura Malfatto, Andrea Saletti, Alessandro De Vito, Roberto Menozzi, Umberto Scoditti, Luigi Simonetti, Andrea Zini, Elvis Lafe, Anna Cavallini, Guido Andrea Lazzarotti, Nicola Giannini, Andrea Boghi, Andrea Naldi, Daniele Romano, Rosa Napoletano, Alessio Comai, Enrica Franchini, Nicola Cavasin, Adriana Critelli, Andrea Giorgianni, Lucia Princiotta Cariddi, Vittorio Semeraro, Giovanni Boero, Domenico Sergio Zimatore, Marco Petruzzellis, Francesco Biraschi, Ettore Nicolini, Alessandro Pedicelli, Giovanni Frisullo, Andrea Calzoni, Tiziana Tassinari, Ivan Gallesio, Federica Sepe, Pietro Filauri, Simona Sacco, Emilio Lozupone, Annalisa Rizzo, Michele Besana, Alessia Giossi, Marco Pavia, Paolo Invernizzi, Pietro Amistà, Monia Russo, Francesco Florio, Vincenzo Inchingolo, Marco Filizzolo, Marina Mannino, Salvatore Mangiafico, Danilo Toni","doi":"10.1007/s10072-024-07638-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Mechanical thrombectomy (MT) was found to be beneficial in acute ischemic stroke patients with anterior tandem occlusion (a-TO). Instead, little is known about the effectiveness of MT in stroke patients with posterior tandem occlusion (p-TO). We aimed to compare MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO.</p><p><strong>Methods: </strong>We conducted a cohort study on prospectively collected data of patients registered in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) who were treated with MT within 24 h from last known well time for acute ischemic stroke with p-TO (n = 275) or a-TO (n = 1853).</p><p><strong>Results: </strong>After adjustment for unbalanced pre-procedure variables (year 2015-2021, age, sex, NIHSS score, ASPECTS, and time strata for puncture groin) and pre-stroke mRS score as pre-defined predictor, p-TO was significantly associated with lower probability of mRS score 0-2 (OR 0.415, 95% CI 0.268-0.644) and with higher risk of death (OR 2.813, 95% CI 2.080-3.805) at 3 months. After adjustment for unbalanced procedural and post-procedure variables (IVT, general anesthesia, TICI 3, and 24-h HT) and pre-stroke mRS score as pre-defined predictor, association between p-TO and lower probability of mRS score 0-2 (OR 0.444, 95% CI 0.304-0.649) and association between p-TO and with higher risk of death (OR 2.971, 95% CI 1.993-4.429) remained significant.</p><p><strong>Conclusions: </strong>MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO was associated with worse outcomes at 3 months.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"5327-5336"},"PeriodicalIF":2.7000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Thrombectomy in ischemic stroke patients with tandem occlusion in the posterior versus anterior circulation.\",\"authors\":\"Manuel Cappellari, Giovanni Pracucci, Valentina Saia, Nicolò Mandruzzato, Francesco Valletta, Fabrizio Sallustio, Ilaria Casetta, Enrico Fainardi, Valerio Da Ros, Marina Diomedi, Francesco Capasso, Patrizia Nencini, Stefano Vallone, Guido Bigliardi, Agostino Tessitore, Paolino La Spina, Sandra Bracco, Rossana Tassi, Mauro Bergui, Paolo Cerrato, Maria Ruggiero, Marco Longoni, Lucio Castellan, Laura Malfatto, Andrea Saletti, Alessandro De Vito, Roberto Menozzi, Umberto Scoditti, Luigi Simonetti, Andrea Zini, Elvis Lafe, Anna Cavallini, Guido Andrea Lazzarotti, Nicola Giannini, Andrea Boghi, Andrea Naldi, Daniele Romano, Rosa Napoletano, Alessio Comai, Enrica Franchini, Nicola Cavasin, Adriana Critelli, Andrea Giorgianni, Lucia Princiotta Cariddi, Vittorio Semeraro, Giovanni Boero, Domenico Sergio Zimatore, Marco Petruzzellis, Francesco Biraschi, Ettore Nicolini, Alessandro Pedicelli, Giovanni Frisullo, Andrea Calzoni, Tiziana Tassinari, Ivan Gallesio, Federica Sepe, Pietro Filauri, Simona Sacco, Emilio Lozupone, Annalisa Rizzo, Michele Besana, Alessia Giossi, Marco Pavia, Paolo Invernizzi, Pietro Amistà, Monia Russo, Francesco Florio, Vincenzo Inchingolo, Marco Filizzolo, Marina Mannino, Salvatore Mangiafico, Danilo Toni\",\"doi\":\"10.1007/s10072-024-07638-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Mechanical thrombectomy (MT) was found to be beneficial in acute ischemic stroke patients with anterior tandem occlusion (a-TO). Instead, little is known about the effectiveness of MT in stroke patients with posterior tandem occlusion (p-TO). We aimed to compare MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO.</p><p><strong>Methods: </strong>We conducted a cohort study on prospectively collected data of patients registered in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) who were treated with MT within 24 h from last known well time for acute ischemic stroke with p-TO (n = 275) or a-TO (n = 1853).</p><p><strong>Results: </strong>After adjustment for unbalanced pre-procedure variables (year 2015-2021, age, sex, NIHSS score, ASPECTS, and time strata for puncture groin) and pre-stroke mRS score as pre-defined predictor, p-TO was significantly associated with lower probability of mRS score 0-2 (OR 0.415, 95% CI 0.268-0.644) and with higher risk of death (OR 2.813, 95% CI 2.080-3.805) at 3 months. After adjustment for unbalanced procedural and post-procedure variables (IVT, general anesthesia, TICI 3, and 24-h HT) and pre-stroke mRS score as pre-defined predictor, association between p-TO and lower probability of mRS score 0-2 (OR 0.444, 95% CI 0.304-0.649) and association between p-TO and with higher risk of death (OR 2.971, 95% CI 1.993-4.429) remained significant.</p><p><strong>Conclusions: </strong>MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO was associated with worse outcomes at 3 months.</p>\",\"PeriodicalId\":19191,\"journal\":{\"name\":\"Neurological Sciences\",\"volume\":\" \",\"pages\":\"5327-5336\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurological Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10072-024-07638-x\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurological Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10072-024-07638-x","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Thrombectomy in ischemic stroke patients with tandem occlusion in the posterior versus anterior circulation.
Background: Mechanical thrombectomy (MT) was found to be beneficial in acute ischemic stroke patients with anterior tandem occlusion (a-TO). Instead, little is known about the effectiveness of MT in stroke patients with posterior tandem occlusion (p-TO). We aimed to compare MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO.
Methods: We conducted a cohort study on prospectively collected data of patients registered in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) who were treated with MT within 24 h from last known well time for acute ischemic stroke with p-TO (n = 275) or a-TO (n = 1853).
Results: After adjustment for unbalanced pre-procedure variables (year 2015-2021, age, sex, NIHSS score, ASPECTS, and time strata for puncture groin) and pre-stroke mRS score as pre-defined predictor, p-TO was significantly associated with lower probability of mRS score 0-2 (OR 0.415, 95% CI 0.268-0.644) and with higher risk of death (OR 2.813, 95% CI 2.080-3.805) at 3 months. After adjustment for unbalanced procedural and post-procedure variables (IVT, general anesthesia, TICI 3, and 24-h HT) and pre-stroke mRS score as pre-defined predictor, association between p-TO and lower probability of mRS score 0-2 (OR 0.444, 95% CI 0.304-0.649) and association between p-TO and with higher risk of death (OR 2.971, 95% CI 1.993-4.429) remained significant.
Conclusions: MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO was associated with worse outcomes at 3 months.
期刊介绍：
Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.
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