Outcomes after reperfusion therapies in patients with ACA stroke: A multicenter cohort study from the EVATRISP collaboration

A. Filioglo; N. Simaan; A. Honig; M. R. Heldner; R. von Rennenberg; A. Pezzini; V. Padjen; A. Rentzos; V. L. Altersberger; P. Baumgartner; A. Zini; I. Grisendi; S. Aladdin; J. M. Gomori; S. M. Pilgram-Pastor; J. F. Scheitz; M. Magoni; I. Berisavac; A. Nordanstig; M. Psychogios; A. Luft; M. Gentile; F. Assenza; M. Arnold; C. H. Nolte; M. Gamba; M. Ercegovac; K. Jood; S. T. Engelter; S. Wegener; S. Forlivesi; M. Zedde; H. Gensicke; T. Tatlisumak; J. E. Cohen; R. R. Leker

doi:10.1016/j.jns.2021.120081

Outcomes after reperfusion therapies in patients with ACA stroke: A multicenter cohort study from the EVATRISP collaboration

A. Filioglo, N. Simaan, A. Honig, M. R. Heldner, R. von Rennenberg, A. Pezzini, V. Padjen, A. Rentzos, V. L. Altersberger, P. Baumgartner, A. Zini, I. Grisendi, S. Aladdin, J. M. Gomori, S. M. Pilgram-Pastor, J. F. Scheitz, M. Magoni, I. Berisavac, A. Nordanstig, M. PsychogiosA. Luft, M. Gentile, F. Assenza, M. Arnold, C. H. Nolte, M. Gamba, M. Ercegovac, K. Jood, S. T. Engelter, S. Wegener, S. Forlivesi, M. Zedde, H. Gensicke, T. Tatlisumak, J. E. Cohen, R. R. Leker

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

Background: Patients with stroke secondary to occlusions of the anterior cerebral artery (ACA) often have poor outcomes. The optimal acute therapeutic intervention for these patients remains unknown. Methods: Patients with isolated ACA-stroke were identified from 10 centers participating in the EndoVascular treatment And ThRombolysis in Ischemic Stroke Patients (EVATRISP) prospective registry. Patients treated with endovascular thrombectomy (EVT) were compared to those treated with intravenous thrombolysis (IVT). Odds ratios with 95% confidence intervals (OR; 95%CI) were calculated using multivariate regression analysis. Results: Included were 92 patients with ACA-stroke. Of the 92 ACA patients, 55 (60%) were treated with IVT only and 37 (40%) with EVT (±bridging IVT). ACA patients treated with EVT had more often wake-up stroke (24% vs. 6%, p = 0.044) and proximal ACA occlusions (43% vs. 24%, p = 0.047) and tended to have higher stroke severity on admission [NIHSS: 10.0 vs 7.0, p = 0.054). However, odds for favorable outcome, mortality or symptomatic intracranial hemorrhage did not differ significantly between both groups. Exploration of the effect of clot location inside the ACA showed that in patients with A1 or A2/A3 ACA occlusions the chances of favorable outcome were not influenced by treatment allocation to IVT or EVT. Discussion: Treatment with either IVT or EVT could be safe with similar effect in patients with ACA-strokes and these effects may be independent of clot location within the occluded ACA.

Original language	English
Article number	120081
Journal	Journal of the Neurological Sciences
Volume	432
DOIs	https://doi.org/10.1016/j.jns.2021.120081
State	Published - 15 Jan 2022
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2021

Funding

J.F. Scheitz received a research grant from Corona-Stiftung (Germany). T. Tatlisumak has/has had research contracts with Bayer, Boehringer Ingelheim, and Portola Pharma. He serves/has served as an advisory board member for Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Lumosa Therapeutics, and Portola Pharma and has received speaker's honoraria from the University of Donau (Austria). He has received academic grants from the European Union , Helsinki University Central Hospital , University of Gothenburg , Sahlgrenska University Hospital , Sigrid Juselius Foundation , and Wennerström Foundation . M. R. Heldner reports personal fees from Bayer and Scientific Advisory Board honoraria from Amgen and grants from the Bangerter Foundation and the Swiss Heart Foundation . H. Gensicke has received research support from the Swiss National Science Foundation , advisory board honoraria from Daiichi Sankyo and funding for travel from BMS/Pfizer. M. R. Heldner reports personal fees from Bayer and Scientific Advisory Board honoraria from Amgen and grants from the Bangerter Foundation and the Swiss Heart Foundation.M. Arnold: received speaker honoraria from Bayer, Boehringer Ingelheim, and Covidien; advisory board honoraria from Amgen, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Pfizer, Medtronic-Covidien, Daiichi Sankyo and Nestlé Health Science; research grant provided by the Swiss Heart Foundation and by the Swiss National Science Foundation (SNSF).C. Nolte received research grants from German Ministry of Research and Education, German Center for Neurodegenerative Diseases, German Center for Cardiovascular Research, and speaker and/or consultation fees from Boehringer Ingelheim, Bristol-Myers Squibb, Pfizer Pharma, Bayer Pharma, Abbott and W.L. Gore and Associates.S. T. Engelter has received funding for travel or speaker honoraria from Bayer Boehringer-Ingelheim, and Daiichi-Sankyo. He has served on scientific advisory boards for Bayer, Boehringer-Ingelheim, BMS/Pfizer, MindMaze and on the editorial board of Stroke. He has received an educational grant from Pfizer, a research grant from Daiichi-Sankyo and Research support from the Science Funds (Wissenschaftsfonds) of the University Hospital Basel, University Department of Geriatric Medicine FELIX PLATTER (Wissenschaftsfonds Rehabilitation), the University Basel, the Swiss Heart Foundation and the Swiss National Science Foundation.S. Wegener received research funds by the Swiss National Science Foundation, the UZH Clinical Research Priority Program (CRPP) stroke, the Swiss Heart foundation, Boehringer- Ingelheim, a speaker's honorarium from Amgen and a consultancy fee from Bayer.H. Gensicke has received research support from the Swiss National Science Foundation, advisory board honoraria from Daiichi Sankyo and funding for travel from BMS/Pfizer.T. Tatlisumak has/has had research contracts with Bayer, Boehringer Ingelheim, and Portola Pharma. He serves/has served as an advisory board member for Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Lumosa Therapeutics, and Portola Pharma and has received speaker's honoraria from the University of Donau (Austria). He has received academic grants from the European Union, Helsinki University Central Hospital, University of Gothenburg, Sahlgrenska University Hospital, Sigrid Juselius Foundation, and Wennerström Foundation.This study was supported in part by the Peritz and Chantal Scheinberg Cerebrovascular Research Fund. C. Nolte received research grants from German Ministry of Research and Education, German Center for Neurodegenerative Diseases, German Center for Cardiovascular Research , and speaker and/or consultation fees from Boehringer Ingelheim, Bristol-Myers Squibb, Pfizer Pharma, Bayer Pharma, Abbott and W.L. Gore and Associates. S. T. Engelter has received funding for travel or speaker honoraria from Bayer Boehringer-Ingelheim, and Daiichi-Sankyo. He has served on scientific advisory boards for Bayer, Boehringer-Ingelheim, BMS/Pfizer, MindMaze and on the editorial board of Stroke. He has received an educational grant from Pfizer, a research grant from Daiichi-Sankyo and Research support from the Science Funds (Wissenschaftsfonds) of the University Hospital Basel, University Department of Geriatric Medicine FELIX PLATTER (Wissenschaftsfonds Rehabilitation), the University Basel , the Swiss Heart Foundation and the Swiss National Science Foundation .

Funders	Funder number
Bangerter Foundation
CRPP
Daiichi
German Ministry of Research and Education, German Center for Neurodegenerative Diseases
Lumosa Therapeutics
Medtronic-Covidien
Portola Pharma
UZH Clinical Research Priority Program
University of Donau
Wennerström Foundation
Amgen
Bristol-Myers Squibb
Pfizer
Bayer
Boehringer Ingelheim
Universität Basel
Helsingin ja Uudenmaan Sairaanhoitopiiri
Deutsches Zentrum für Herz-Kreislaufforschung
Corona-Stiftung
European Commission
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
Covidien
Daiichi-Sankyo
Schweizerische Herzstiftung
Sahlgrenska Universitetssjukhuset
Göteborgs Universitet
Sigrid Juséliuksen Säätiö

Keywords

Anterior cerebral artery
Cerebrovascular disease
Endovascular
Stroke
Thrombectomy

Access to Document

10.1016/j.jns.2021.120081

Cite this

Filioglo, A., Simaan, N., Honig, A., Heldner, M. R., von Rennenberg, R., Pezzini, A., Padjen, V., Rentzos, A., Altersberger, V. L., Baumgartner, P., Zini, A., Grisendi, I., Aladdin, S., Gomori, J. M., Pilgram-Pastor, S. M., Scheitz, J. F., Magoni, M., Berisavac, I., Nordanstig, A., ... Leker, R. R. (2022). Outcomes after reperfusion therapies in patients with ACA stroke: A multicenter cohort study from the EVATRISP collaboration. Journal of the Neurological Sciences, 432, Article 120081. https://doi.org/10.1016/j.jns.2021.120081

@article{bfa67ec3296f467fa02a8c85055e0588,

title = "Outcomes after reperfusion therapies in patients with ACA stroke: A multicenter cohort study from the EVATRISP collaboration",

abstract = "Background: Patients with stroke secondary to occlusions of the anterior cerebral artery (ACA) often have poor outcomes. The optimal acute therapeutic intervention for these patients remains unknown. Methods: Patients with isolated ACA-stroke were identified from 10 centers participating in the EndoVascular treatment And ThRombolysis in Ischemic Stroke Patients (EVATRISP) prospective registry. Patients treated with endovascular thrombectomy (EVT) were compared to those treated with intravenous thrombolysis (IVT). Odds ratios with 95% confidence intervals (OR; 95%CI) were calculated using multivariate regression analysis. Results: Included were 92 patients with ACA-stroke. Of the 92 ACA patients, 55 (60%) were treated with IVT only and 37 (40%) with EVT (±bridging IVT). ACA patients treated with EVT had more often wake-up stroke (24% vs. 6%, p = 0.044) and proximal ACA occlusions (43% vs. 24%, p = 0.047) and tended to have higher stroke severity on admission [NIHSS: 10.0 vs 7.0, p = 0.054). However, odds for favorable outcome, mortality or symptomatic intracranial hemorrhage did not differ significantly between both groups. Exploration of the effect of clot location inside the ACA showed that in patients with A1 or A2/A3 ACA occlusions the chances of favorable outcome were not influenced by treatment allocation to IVT or EVT. Discussion: Treatment with either IVT or EVT could be safe with similar effect in patients with ACA-strokes and these effects may be independent of clot location within the occluded ACA.",

keywords = "Anterior cerebral artery, Cerebrovascular disease, Endovascular, Stroke, Thrombectomy",

author = "A. Filioglo and N. Simaan and A. Honig and Heldner, {M. R.} and {von Rennenberg}, R. and A. Pezzini and V. Padjen and A. Rentzos and Altersberger, {V. L.} and P. Baumgartner and A. Zini and I. Grisendi and S. Aladdin and Gomori, {J. M.} and Pilgram-Pastor, {S. M.} and Scheitz, {J. F.} and M. Magoni and I. Berisavac and A. Nordanstig and M. Psychogios and A. Luft and M. Gentile and F. Assenza and M. Arnold and Nolte, {C. H.} and M. Gamba and M. Ercegovac and K. Jood and Engelter, {S. T.} and S. Wegener and S. Forlivesi and M. Zedde and H. Gensicke and T. Tatlisumak and Cohen, {J. E.} and Leker, {R. R.}",

note = "Publisher Copyright: {\textcopyright} 2021",

year = "2022",

month = jan,

day = "15",

doi = "10.1016/j.jns.2021.120081",

language = "אנגלית",

volume = "432",

journal = "Journal of the Neurological Sciences",

issn = "0022-510X",

publisher = "Elsevier B.V.",

}

Filioglo, A, Simaan, N, Honig, A, Heldner, MR, von Rennenberg, R, Pezzini, A, Padjen, V, Rentzos, A, Altersberger, VL, Baumgartner, P, Zini, A, Grisendi, I, Aladdin, S, Gomori, JM, Pilgram-Pastor, SM, Scheitz, JF, Magoni, M, Berisavac, I, Nordanstig, A, Psychogios, M, Luft, A, Gentile, M, Assenza, F, Arnold, M, Nolte, CH, Gamba, M, Ercegovac, M, Jood, K, Engelter, ST, Wegener, S, Forlivesi, S, Zedde, M, Gensicke, H, Tatlisumak, T, Cohen, JE & Leker, RR 2022, 'Outcomes after reperfusion therapies in patients with ACA stroke: A multicenter cohort study from the EVATRISP collaboration', Journal of the Neurological Sciences, vol. 432, 120081. https://doi.org/10.1016/j.jns.2021.120081

TY - JOUR

T1 - Outcomes after reperfusion therapies in patients with ACA stroke

T2 - A multicenter cohort study from the EVATRISP collaboration

AU - Filioglo, A.

AU - Simaan, N.

AU - Honig, A.

AU - Heldner, M. R.

AU - von Rennenberg, R.

AU - Pezzini, A.

AU - Padjen, V.

AU - Rentzos, A.

AU - Altersberger, V. L.

AU - Baumgartner, P.

AU - Zini, A.

AU - Grisendi, I.

AU - Aladdin, S.

AU - Gomori, J. M.

AU - Pilgram-Pastor, S. M.

AU - Scheitz, J. F.

AU - Magoni, M.

AU - Berisavac, I.

AU - Nordanstig, A.

AU - Psychogios, M.

AU - Luft, A.

AU - Gentile, M.

AU - Assenza, F.

AU - Arnold, M.

AU - Nolte, C. H.

AU - Gamba, M.

AU - Ercegovac, M.

AU - Jood, K.

AU - Engelter, S. T.

AU - Wegener, S.

AU - Forlivesi, S.

AU - Zedde, M.

AU - Gensicke, H.

AU - Tatlisumak, T.

AU - Cohen, J. E.

AU - Leker, R. R.

PY - 2022/1/15

Y1 - 2022/1/15

N2 - Background: Patients with stroke secondary to occlusions of the anterior cerebral artery (ACA) often have poor outcomes. The optimal acute therapeutic intervention for these patients remains unknown. Methods: Patients with isolated ACA-stroke were identified from 10 centers participating in the EndoVascular treatment And ThRombolysis in Ischemic Stroke Patients (EVATRISP) prospective registry. Patients treated with endovascular thrombectomy (EVT) were compared to those treated with intravenous thrombolysis (IVT). Odds ratios with 95% confidence intervals (OR; 95%CI) were calculated using multivariate regression analysis. Results: Included were 92 patients with ACA-stroke. Of the 92 ACA patients, 55 (60%) were treated with IVT only and 37 (40%) with EVT (±bridging IVT). ACA patients treated with EVT had more often wake-up stroke (24% vs. 6%, p = 0.044) and proximal ACA occlusions (43% vs. 24%, p = 0.047) and tended to have higher stroke severity on admission [NIHSS: 10.0 vs 7.0, p = 0.054). However, odds for favorable outcome, mortality or symptomatic intracranial hemorrhage did not differ significantly between both groups. Exploration of the effect of clot location inside the ACA showed that in patients with A1 or A2/A3 ACA occlusions the chances of favorable outcome were not influenced by treatment allocation to IVT or EVT. Discussion: Treatment with either IVT or EVT could be safe with similar effect in patients with ACA-strokes and these effects may be independent of clot location within the occluded ACA.

AB - Background: Patients with stroke secondary to occlusions of the anterior cerebral artery (ACA) often have poor outcomes. The optimal acute therapeutic intervention for these patients remains unknown. Methods: Patients with isolated ACA-stroke were identified from 10 centers participating in the EndoVascular treatment And ThRombolysis in Ischemic Stroke Patients (EVATRISP) prospective registry. Patients treated with endovascular thrombectomy (EVT) were compared to those treated with intravenous thrombolysis (IVT). Odds ratios with 95% confidence intervals (OR; 95%CI) were calculated using multivariate regression analysis. Results: Included were 92 patients with ACA-stroke. Of the 92 ACA patients, 55 (60%) were treated with IVT only and 37 (40%) with EVT (±bridging IVT). ACA patients treated with EVT had more often wake-up stroke (24% vs. 6%, p = 0.044) and proximal ACA occlusions (43% vs. 24%, p = 0.047) and tended to have higher stroke severity on admission [NIHSS: 10.0 vs 7.0, p = 0.054). However, odds for favorable outcome, mortality or symptomatic intracranial hemorrhage did not differ significantly between both groups. Exploration of the effect of clot location inside the ACA showed that in patients with A1 or A2/A3 ACA occlusions the chances of favorable outcome were not influenced by treatment allocation to IVT or EVT. Discussion: Treatment with either IVT or EVT could be safe with similar effect in patients with ACA-strokes and these effects may be independent of clot location within the occluded ACA.

KW - Anterior cerebral artery

KW - Cerebrovascular disease

KW - Endovascular

KW - Stroke

KW - Thrombectomy

UR - http://www.scopus.com/inward/record.url?scp=85121128674&partnerID=8YFLogxK

U2 - 10.1016/j.jns.2021.120081

DO - 10.1016/j.jns.2021.120081

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???

C2 - 34920158

AN - SCOPUS:85121128674

SN - 0022-510X

VL - 432

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

M1 - 120081

ER -

Outcomes after reperfusion therapies in patients with ACA stroke: A multicenter cohort study from the EVATRISP collaboration

Abstract

Bibliographical note

Funding

Keywords

Access to Document

Other files and links

Fingerprint

Cite this