Reperfusion therapy in acute ischaemic stroke due to cervical and cerebral artery dissection: Results from a Spanish multicentre study.

Data de publicació: 01/07/2023 Data Ahead of Print: 13/07/2022

Autors de IIS La Fe

José Ignacio Tembl Ferrairo

Autor

Autors aliens a IIS La Fe

Campo-Caballero D
de la Riva P
de Arce A
Martínez-Zabaleta M
Rodríguez-Antigüedad J
Ekiza J
Iruzubieta P
Purroy F
Fuentes B
de Lera Alfonso M
Krupinski J
Mengual Chirife JJ
Palomeras E
Guisado-Alonso D
Rodríguez-Yáñez M
Ustrell X
Tejada García J
de Felipe Mimbrera A
Paré-Curell M
Cajaraville S
Garcés M
Serena J

Grups d'Investigació

Unidad Mixta de Investigación Cerebrovascular

Leader

Juan Bautista Salom Sanvalero

Abstract

INTRODUCTION: Ischaemic stroke (IS) due to cervical and cerebral artery dissection (CAD) is a rare entity, and few data are available on the use of such reperfusion therapies as intravenous fibrinolysis and mechanical thrombectomy in these patients. We analysed the use of these treatments in patients with IS due to CAD and compared them against patients receiving reperfusion treatment for IS of other aetiologies. METHODS: We conducted an observational, retrospective, multicentre study of patients with IS due to CAD recorded in the National Stroke Registry of the Spanish Society of Neurology during the period 2011-2019. Comparative analyses were performed between: a) patients with CAD treated and not treated with reperfusion therapies and b) patients treated with reperfusion for IS due to CAD and patients treated with reperfusion for IS due to other causes. Epidemiological data, stroke variables, and outcomes at discharge and at 3 months were included in the analysis. RESULTS: The study included 21,037 patients with IS: 223 (1%) had IS due to CAD, of whom 68 (30%) received reperfusion treatment. Reperfusion treatments were used less frequently in cases of vertebral artery dissection and more frequently in patients with carotid artery occlusion. Compared to patients with IS due to other causes, patients with CAD were younger, more frequently underwent mechanical thrombectomy, and less frequently received intravenous fibrinolysis. Rates of haemorrhagic complications, mortality, and independence at 3 months were similar in both groups. CONCLUSIONS: Reperfusion therapy is frequently used in patients with IS due to CAD. The outcomes of these patients demonstrate the efficacy and safety of reperfusion treatments, and are comparable to the outcomes of patients with IS due to other aetiologies.

Dades de la publicació

ISSN/ISSNe:: 2173-5808, 2173-5808
Tipus:: Article
Pàgines:: 412-418
DOI:: 10.1016/j.nrleng.2020.10.012
PubMed:: 35842129

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Keywords

Disección; Dissection; Fibrinolisis; Fibrinolysis; Ictus; Reperfusion; Reperfusión; Stroke; Thrombectomy; Trombectomía

Projectes associats

AVANCES EN EL ESTUDIO DE LA REACTIVIDAD PLAQUETARIA Y SU INTERACCION CON LOS ERITROCITOS: BASES MOLECUALRES Y APLICABILIDAD CLINICO-FARMACOLOGICA

Investigador Principal: JUANA VALLES GINER

PI03/0270 . INSTITUTO DE SALUD CARLOS III . 2004

RED DE INVESTIGACION (RENEVAS)

Investigador Principal: ENRIQUE ALBORCH DOMÍNGUEZ

RD06/0026/0006 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN INSTITUTO DE INVESTIGACIÓN SANITARIA DE SANTIAGO DE COMPOSTELA (FIDIS); FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006