Mechanical thrombectomy practices in France: Exhaustive survey of centers and individual operators

Forestier, Géraud; Kerleroux, Basile; Janot, Kévin; Zhu, François; Dumas, Victor; Hak, Jean-François; Shotar, Eimad; Hassen, Wagih Ben; Bourcier, Romain; Soize, Sébastien; Berge, Jérôme; Naggara, Olivier; Desal, Hubert; Boulouis, Grégoire; Rouchaud, Aymeric; Hanafi, Riyad; Girot, Jean‐Baptiste; Charbonnier, Guillaume; Biondi, Alessandra; Gariel, Florent; Marnat, Gaultier; Gentric, Jean-Christophe; Barbier, Charlotte; Chabert, Emmanuel; Lebedinsky, Pablo Ariel; Tuilier, Titien; Thouant, Pierre; Comby, Pierre-Olivier; Mejdoubi, Mehdi; Heck, Olivier; Kastler, Adrian; Chalumeau, Vanessa; Caroff, Jildaz; Personnic, Thomas; Marchal, Adrien; Bogey, C.; Carle, Xavier; Dargazanli, Cyril; Derraz, Imad; Gory, Benjamin; Détraz, Lili; Sédat, Jacques; Zurlinden, O.; Escalard, Simon; Fahed, Robert; Guédon, Alexis; Civelli, Vittorio; Premat, Kévin; Clarençon, Frédéric; Ducouret, E.; Velasco, Stéphane; Manceau, Pierre François; Paya, Christophe; François, Ετιεννε; Moa, J. Le; Papagiannaki, Chrisanthi; Aggour, M.; Bintner, M.; Veyrières, J.-B.; Richter, Johann Sebastian; Pop, Raoul; Consoli, Arturo; Di-Maria, F.; Artéaga, Charles; Darcourt, Jean; Michelozzi, Caterina; Guédin, Pierre; Herbreteau, Denis; Bras, Alexandra Le

doi:10.1016/j.neurad.2020.05.001

Cited by 15 publications

(4 citation statements)

References 11 publications

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“…Results from the meta-analysis showed a reperfusion rate of 50%. This higher reperfusion rate observed in the Maurer et al's series and in the present case series (MASC data) may be explained by the recent progresses in MT techniques, like the use of combined techniques (SR + contact aspiration), which is one of the most widespread procedure in many centers, including France (24). However, this reperfusion rate (56%) remains lower than the one observed in meta-analyses for regular MT (25) (Supplemental Results).…”

Section: Discussionsupporting

confidence: 48%

Benefit of mechanical thrombectomy in acute ischemic stroke related to calcified cerebral embolus

Grand

Dargazanli

Papagiannaki

et al. 2022

Journal of Neuroradiology

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Section: Discussionsupporting

confidence: 48%

Benefit of mechanical thrombectomy in acute ischemic stroke related to calcified cerebral embolus

Grand

Dargazanli

Papagiannaki

et al. 2022

Journal of Neuroradiology

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“…Moreover, it is a selection bias that the MT data come from 8 different hospitals whereas the BMM group is from only 1 center. The use of MRI, first-line imaging in almost all French centers, 32 makes our results less generalizable to geographic regions using CT.…”

Section: Discussionmentioning

confidence: 81%

Relevance of Brain Regions' Eloquence Assessment in Patients With a Large Ischemic Core Treated With Mechanical Thrombectomy

et al. 2021

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ObjectiveIndividualized patient selection for mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS) and large ischemic core (LIC) at baseline is an unmet need.We tested the hypothesis, that assessing the functional relevance of both the infarcted and hypo-perfused brain tissue, would improve the selection framework of patients with LIC for MT.MethodsMulticenter, retrospective, study of adult with LIC (ischemic core volume > 70ml on MR-DWI), with MRI perfusion, treated with MT or best medical management (BMM).Primary outcome was 3-month modified-Rankin-Scale (mRS), favourable if 0-3. Global and regional-eloquence-based core-perfusion mismatch ratios were derived. The predictive accuracy for clinical outcome of eloquent regions involvement was compared in multivariable and bootstrap-random-forest models.ResultsA total of 138 patients with baseline LIC were included (MT n=96 or BMM n=42; mean age±SD, 72.4±14.4years; 34.1% females; mRS=0-3: 45.1%). Mean core and critically-hypo-perfused volume were 100.4ml±36.3ml and 157.6±56.2ml respectively and did not differ between groups. Models considering the functional relevance of the infarct location showed a better accuracy for the prediction of mRS=0-3 with a c-Statistic of 0.76 and 0.83 for logistic regression model and bootstrap-random-forest testing sets respectively. In these models, the interaction between treatment effect of MT and the mismatch was significant (p=0.04). In comparison in the logistic regression model disregarding functional eloquence the c-Statistic was 0.67 and the interaction between MT and the mismatch was insignificant.ConclusionConsidering functional eloquence of hypo-perfused tissue in patients with a large infarct core at baseline allows for a more precise estimation of treatment expected benefit.

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“…And, since mechanical thrombectomy needs to be performed by a qualified neurointerventionist at comprehensive stroke centers, most hospitals remain unqualified to provide treatment. In France out of 135 nationwide neurovascular centers, only 40 are capable of performing thrombectomy to date (Forestier et al, 2020 ). Thus, finding innovative solutions for the treatment of ischemic stroke remains an open area of research, and nanodrugs are emerging as a promising strategy to improve the efficacy and safety of thrombolytic therapy due to their thrombotic targeting, stability, and targeted release.…”

Section: Nanomaterials-based Drug Deliverymentioning

confidence: 99%

Recent Advances in Nanomaterials for Diagnosis, Treatments, and Neurorestoration in Ischemic Stroke

Lin

Tang

2022

Front. Cell. Neurosci.

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Stroke is a major public health issue, corresponding to the second cause of mortality and the first cause of severe disability. Ischemic stroke is the most common type of stroke, accounting for 87% of all strokes, where early detection and clinical intervention are well known to decrease its morbidity and mortality. However, the diagnosis of ischemic stroke has been limited to the late stages, and its therapeutic window is too narrow to provide rational and effective treatment. In addition, clinical thrombolytics suffer from a short half-life, inactivation, allergic reactions, and non-specific tissue targeting. Another problem is the limited ability of current neuroprotective agents to promote recovery of the ischemic brain tissue after stroke, which contributes to the progressive and irreversible nature of ischemic stroke and also the severity of the outcome. Fortunately, because of biomaterials’ inherent biochemical and biophysical properties, including biocompatibility, biodegradability, renewability, nontoxicity, long blood circulation time, and targeting ability. Utilization of them has been pursued as an innovative and promising strategy to tackle these challenges. In this review, special emphasis will be placed on the recent advances in the study of nanomaterials for the diagnosis and therapy of ischemic stroke. Meanwhile, nanomaterials provide much promise for neural tissue salvage and regeneration in brain ischemia, which is also highlighted.

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Mechanical thrombectomy practices in France: Exhaustive survey of centers and individual operators

Cited by 15 publications

References 11 publications

Benefit of mechanical thrombectomy in acute ischemic stroke related to calcified cerebral embolus

Benefit of mechanical thrombectomy in acute ischemic stroke related to calcified cerebral embolus

Relevance of Brain Regions' Eloquence Assessment in Patients With a Large Ischemic Core Treated With Mechanical Thrombectomy

Recent Advances in Nanomaterials for Diagnosis, Treatments, and Neurorestoration in Ischemic Stroke

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