Artery occlusion independently predicts unfavorable outcome in cervical artery dissection / Christopher Traenka, Caspar Grond-Ginsbach, Barbara Goeggel Simonetti, Tiina M. Metso, Stéphanie Debette, Alessandro Pezzini, Manja Kloss, Jennifer J. Majersik, Andrew M. Southerland, Didier Leys, Ralf Baumgartner, Valeria Caso, Yannick Béjot, Gian Marco De Marchis, Urs Fischer, Alexandros Polymeris, Hakan Sarikaya, Vincent Thijs, Bradford B. Worrall, Anna Bersano, Tobias Brandt, Henrik Gensicke, Leo H. Bonati, Emmanuel Touzeé, Juan J. Martin, Hugues Chabriat, Turgut Tatlisumak, Marcel Arnold, Stefan T. Engelter, Philippe Lyrer, for the CADISP-Plus Study Group

OBJECTIVE: To assess the impact of dissected artery occlusion (DAO) on functional outcome and complications in patients with cervical artery dissection (CeAD). - METHODS: We analyzed combined individual patient data from 3 multicenter cohorts of consecutive patients with CeAD (the Cervical Artery Dissection and Ischemic Stroke Patients [CADISP]-Plus consortium dataset). Patients with data on DAO and functional outcome were included. We compared patients with DAO to those without DAO. Primary outcome was favorable functional outcome (i.e., modified Rankin Scale [mRS] score 0-1) measured 3-6 months from baseline. Secondary outcomes included delayed cerebral ischemia, major hemorrhage, recurrent CeAD, and death. We performed univariate and multivariable binary logistic regression analyses and calculated odds ratios (OR) with 95% confidence intervals (CI), with adjustment for potential confounders. - RESULTS: Of 2,148 patients (median age 45 years [interquartile range (IQR) 38-52], 43.6% women), 728 (33.9%) had DAO. Patients with DAO more frequently presented with cerebral ischemia (84.6% vs 58.5%, p < 0.001). Patients with DAO were less likely to have favorable outcome when compared to patients without DAO (mRS 0-1: 59.6% vs 80.1%, punadjusted < 0.001). After adjustment for age, sex, and initial stroke severity, DAO was independently associated with less favorable outcome (mRS 0-1: OR 0.65, CI 0.50-0.84, p = 0.001). Delayed cerebral ischemia occurred more frequently in patients with DAO than in patients without DAO (4.5% vs 2.9%, p = 0.059). - CONCLUSION: DAO independently predicts less favorable functional outcome in patients with CeAD. Further research on vessel patency, collateral status and effects of revascularization therapies particularly in patients with DAO is warranted..

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:94

Enthalten in:

Neurology - 94(2020), 2, Seite e170-e180

Sprache:

Englisch

Beteiligte Personen:

Tränka, Christopher, 1984- [VerfasserIn]
Grond-Ginsbach, Caspar [VerfasserIn]
Goeggel Simonetti, Barbara [VerfasserIn]
Metso, Tiina M. [VerfasserIn]
Debette, Stéphanie [VerfasserIn]
Pezzini, Alessandro, 1959- [VerfasserIn]
Kloss, Manja, 1972- [VerfasserIn]
Majersik, Jennifer J. [VerfasserIn]
Southerland, Andrew M. [VerfasserIn]
Leys, Didier [VerfasserIn]
Baumgartner, Ralf [VerfasserIn]
Caso, Valeria [VerfasserIn]
Béjot, Yannick [VerfasserIn]
De Marchis, Gian Marco [VerfasserIn]
Fischer, Urs [VerfasserIn]
Polymeris, Alexandros [VerfasserIn]
Sarikaya, Hakan [VerfasserIn]
Thijs, Vincent [VerfasserIn]
Worrall, Bradford B. [VerfasserIn]
Bersano, Anna [VerfasserIn]
Brandt, Tobias [VerfasserIn]
Gensicke, Henrik [VerfasserIn]
Bonati, Leo H. [VerfasserIn]
Touzeé, Emmanuel [VerfasserIn]
Martin, Juan J. [VerfasserIn]
Chabriat, Hugues [VerfasserIn]
Tatlisumak, Turgut [VerfasserIn]
Arnold, Marcel [VerfasserIn]
Engelter, Stefan T. [VerfasserIn]
Lyrer, Philippe [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Adult
Aged
Aneurysm, Dissecting
Cerebral Arterial Diseases
Cerebrovascular Disorders
Female
Humans
Male
Middle Aged
Recovery of Function

Anmerkungen:

First published November 22, 2019

Gesehen am 29.06.2020

Umfang:

11

doi:

10.1212/WNL.0000000000008654

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

1702887480

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