24-Hour Carotid Stent Patency and Outcomes After Endovascular Therapy: A Multicenter Study. Issue 1 (27th December 2022)

• Record Type: Journal Article
• Authors: Allard, Julien; Delvoye, François; Pop, Raoul; Labreuche, Julien; Maier, Benjamin; Marnat, Gaultier; Sibon, Igor; Zhu, François; Lapergue, Bertrand; Consoli, Arturo; Spelle, Laurent; Denier, Christian; Richard, Sébastien; Piotin, Michel; Gory, Benjamin; Mazighi, Mikael
• Other Names: Blanc Raphael author non-byline.; Redjem Hocine author non-byline.; Escalard Simon author non-byline.; Dessilles Jean-Philippe author non-byline.; Delvoye François author non-byline.; Smajda Stanislas author non-byline.; Maier Benjamin author non-byline.; Solène Hebert author non-byline.; Mazighi Mikael author non-byline.; Obadia Mikael author non-byline.; Sabben Candice author non-byline.; Pierre Seners author non-byline.; Igor Raynouard author non-byline.; Corabianu Ovide author non-byline.; de Broucker Thomas author non-byline.; Manchon Eric author non-byline.; Taylor Guillaume author non-byline.; Maacha Malek Ben author non-byline.; Thion Laurie-Anne author non-byline.; Augustin Lecler author non-byline.; Julien Savatovsjy author non-byline.; Wang Adrien author non-byline.; Evrard Serge author non-byline.; Tchikviladze Maya author non-byline.; Ajili Nadia author non-byline.; WeisenburgerLile David author non-byline.; Gorza Lucas author non-byline.; Buard Géraldine author non-byline.; Coskun Oguzhan author non-byline.; Di Maria Federico author non-byline.; Rodesh Georges author non-byline.; Zimatore Sergio author non-byline.; Leguen Morgan author non-byline.; Gratieux Julie author non-byline.; Pico Fernando author non-byline.; Rakotoharinandrasana Haja author non-byline.; Tassan Philippe author non-byline.; Poll Roxanna author non-byline.; Marinier Sylvie author non-byline.; Barreau Xavier author non-byline.; Berge Jérôme author non-byline.; Menegon Patrice author non-byline.; Lucas Ludovic author non-byline.; Olindo Stéphane author non-byline.; Renou Pauline author non-byline.; Sagnier Sharmila author non-byline.; Poli Mathilde author non-byline.; Debruxelles Sabrina author non-byline.; Rouanet François author non-byline.; Tourdias Thomas author non-byline.; Liegey Jean-Sebastien author non-byline.; Briau Pierre author non-byline.; Pangon Nicolas author non-byline.; Coussy Alexis author non-byline.; Papillon Lisa author non-byline.; Papaxanthos Jean author non-byline.; Detraz Lili author non-byline.; Daumas-Duport Benjamin author non-byline.; Alexandre Pierre-Louis author non-byline.; Roy Monica author non-byline.; Lenoble Cédric author non-byline.; Desal Hubert author non-byline.; Guillon Benoît author non-byline.; de Gaalon Solène author non-byline.; Preterre Cécile author non-byline.; Bracard Serge author non-byline.; Anxionnat René author non-byline.; Braun Marc author non-byline.; Derelle Anne-Laure author non-byline.; Tonnelet Romain author non-byline.; Liao Liang author non-byline.; Zhu François author non-byline.; Schmitt Emmanuelle author non-byline.; Planel Sophie author non-byline.; Humbertjean Lisa author non-byline.; Lacour Jean-Christophe author non-byline.; Riou-Comte Nolwenn author non-byline.; Voicu Marcela author non-byline.; Alb Lionel author non-byline.; Reitter Marie author non-byline.; Brezeanu Madalina author non-byline.; Masson Agnès author non-byline.; Tabarna Adriana author non-byline.; Podar Iona author non-byline.; Macian-Montoro Francisco author non-byline.; Saleme Suzanna author non-byline.; Mounayer Charbel author non-byline.; Rouchaud Aymeric author non-byline.; Costalat Vincent author non-byline.; Arquizan Caroline author non-byline.; Dargazanli Cyril author non-byline.; Gascou Grégory author non-byline.; Lefèvre Pierre-Henri author non-byline.; Derraz Imad author non-byline.; Riquelme Carlos author non-byline.; Gaillard Nicolas author non-byline.; Mourand Isabelle author non-byline.; Corti Lucas author non-byline.; Cagnazzo Federico author non-byline.; Ter Schiphorst Adrien author non-byline.; Ferre Jean-Christophe author non-byline.; Raoult Hélène author non-byline.; Ronziere Thomas author non-byline.; Lassale Maria author non-byline.; Paya Christophe author non-byline.; Gauvrit Jean-Yves author non-byline.; Tracol Clément author non-byline.; Langnier-Lemercier Sophie author non-byline.;
• Is Part Of: Stroke. Volume 54:Issue 1(2023)
• Page Start: 124
• Page End: 131
• Publication Date: 2022-12-27
• Subjects: carotid artery stenting -- stent occlusion -- stroke -- thrombectomy; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.122.039797
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background: Management of extracranial internal carotid artery steno-occlusive lesion during endovascular therapy remains debated. Stent occlusion within 24 hours of endovascular therapy is a frequent event after acute carotid artery stenting, and we currently lack large population results. We investigated the incidence, predictors, and clinical impact of stent occlusion after acute carotid artery stenting in current clinical practice. Methods: Patients treated by endovascular therapy with acute carotid artery stenting between 2015 and 2019 in 5 large-volume endovascular-capable centers were retrospectively analyzed. Patients were separated in 2 groups according to the stent patency at 24 hours after carotid artery stenting. We compared baseline characteristics, treatment modalities, and clinical outcome depending on 24-hour stent patency. Primary end point was favorable outcome, defined as a modified Rankin Scale score 0–2 at 3 months. Results: A stent occlusion was observed in 47/225 patients (20.9%). Patients with stent patency had a lower baseline National Institutes of Health Stroke Scale (median [interquartile range]: 13 [7–17] versus 18 [12–21]) and had more often stroke of atherothrombotic origin (77.0% versus 53.2%). A higher stent patency rate was found for patients treated with P2Y12 antagonists at the acute phase (odds ratio [OR]‚ 2.95 [95% CI‚ 1.10–7.91]; P =0.026) and treated with angioplasty (OR‚ 2.42 [95% CI‚ 1.24–4.67]; P =0.008). A better intracranial angiographic reperfusion was observed in patients with 24-hour stent patency compared with patients without stent patency (OR‚ 8.38 [95% CI‚ 3.07–22.78]; P <0.001). Patients with a stent patency at 24 hours had a higher chance of favorable outcome (OR‚ 3.29 [95% CI, 1.66–6.52]; P <0.001) and a lower risk of death (OR‚ 0.32 [95% CI, 0.13–0.76]; P =0.009). Conclusions: One out of 5 patients treated with carotid artery stenting during endovascular therapy presented a stent occlusion within 24 hours. This event was associated with worse functional outcome. Stroke etiology, P2Y12 antagonist administration, quality of intracranial reperfusion, and angioplasty were associated with 24-hour stent patency.