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Gadolinium-Enhanced Extracranial MRA Prior to Mechanical Thrombectomy Is Not Associated With an Improved Procedure Speed
Objectives: To assess whether performing a pre-intervention gadolinium-enhanced extracranial magnetic resonance angiogram (MRA) in addition to intracranial vascular imaging is associated with improved thrombectomy time metrics. Methods: Consecutive patients treated by MT at a large comprehensive str...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333645/ https://www.ncbi.nlm.nih.gov/pubmed/30687224 http://dx.doi.org/10.3389/fneur.2018.01171 |
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author | Guenego, Adrien Khoury, Naim Blanc, Raphaël Mazighi, Mikael Smajda, Stanislas Redjem, Hocine Ciccio, Gabriele Desilles, Jean-Philippe Escalard, Simon Zuber, Kevin Chamard, Pauline Hamdani, Mylène Brikci-Nigassa, Nahida Ben Maacha, Malek Piotin, Michel Fahed, Robert |
author_facet | Guenego, Adrien Khoury, Naim Blanc, Raphaël Mazighi, Mikael Smajda, Stanislas Redjem, Hocine Ciccio, Gabriele Desilles, Jean-Philippe Escalard, Simon Zuber, Kevin Chamard, Pauline Hamdani, Mylène Brikci-Nigassa, Nahida Ben Maacha, Malek Piotin, Michel Fahed, Robert |
author_sort | Guenego, Adrien |
collection | PubMed |
description | Objectives: To assess whether performing a pre-intervention gadolinium-enhanced extracranial magnetic resonance angiogram (MRA) in addition to intracranial vascular imaging is associated with improved thrombectomy time metrics. Methods: Consecutive patients treated by MT at a large comprehensive stroke center between January 2012 and December 2017 who were screened using pre-intervention MRI were included. Patients characteristics and procedural data were collected. Univariate and multivariate analysis were performed to compare MT speed, efficacy, complications, and clinical outcomes between patients with and without pre-intervention gadolinium-enhanced extracranial MRA. Results: A total of 912 patients were treated within the study period, including 288 (31.6%) patients with and 624 (68.4%) patients without extracranial MRA. Multivariate analysis showed no significant difference between groups in groin puncture to clot contact time (RR = 0.93 [0.85–1.02], p = 0.14) or to recanalization time (RR = 0.92 [0.83–1.03], p = 0.15), rates of successful recanalization (defined as a mTICI 2b or 3, RR = 0.93 [0.62–1.42], p = 0.74), procedural complications (RR = 0.81 [0.51–1.27], p = 0.36), and good clinical outcome (defined by a mRS ≤ 2 at 3 months follow-up, RR = 1.05 [0.73–1.52], p = 0.79). Conclusion: Performing a pre-intervention gadolinium-enhanced extracranial MRA in addition to non-contrast intracranial MRA at stroke onset does not seem to be associated with a delay or shortening of procedure times. |
format | Online Article Text |
id | pubmed-6333645 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-63336452019-01-25 Gadolinium-Enhanced Extracranial MRA Prior to Mechanical Thrombectomy Is Not Associated With an Improved Procedure Speed Guenego, Adrien Khoury, Naim Blanc, Raphaël Mazighi, Mikael Smajda, Stanislas Redjem, Hocine Ciccio, Gabriele Desilles, Jean-Philippe Escalard, Simon Zuber, Kevin Chamard, Pauline Hamdani, Mylène Brikci-Nigassa, Nahida Ben Maacha, Malek Piotin, Michel Fahed, Robert Front Neurol Neurology Objectives: To assess whether performing a pre-intervention gadolinium-enhanced extracranial magnetic resonance angiogram (MRA) in addition to intracranial vascular imaging is associated with improved thrombectomy time metrics. Methods: Consecutive patients treated by MT at a large comprehensive stroke center between January 2012 and December 2017 who were screened using pre-intervention MRI were included. Patients characteristics and procedural data were collected. Univariate and multivariate analysis were performed to compare MT speed, efficacy, complications, and clinical outcomes between patients with and without pre-intervention gadolinium-enhanced extracranial MRA. Results: A total of 912 patients were treated within the study period, including 288 (31.6%) patients with and 624 (68.4%) patients without extracranial MRA. Multivariate analysis showed no significant difference between groups in groin puncture to clot contact time (RR = 0.93 [0.85–1.02], p = 0.14) or to recanalization time (RR = 0.92 [0.83–1.03], p = 0.15), rates of successful recanalization (defined as a mTICI 2b or 3, RR = 0.93 [0.62–1.42], p = 0.74), procedural complications (RR = 0.81 [0.51–1.27], p = 0.36), and good clinical outcome (defined by a mRS ≤ 2 at 3 months follow-up, RR = 1.05 [0.73–1.52], p = 0.79). Conclusion: Performing a pre-intervention gadolinium-enhanced extracranial MRA in addition to non-contrast intracranial MRA at stroke onset does not seem to be associated with a delay or shortening of procedure times. Frontiers Media S.A. 2019-01-09 /pmc/articles/PMC6333645/ /pubmed/30687224 http://dx.doi.org/10.3389/fneur.2018.01171 Text en Copyright © 2019 Guenego, Khoury, Blanc, Mazighi, Smajda, Redjem, Ciccio, Desilles, Escalard, Zuber, Chamard, Hamdani, Brikci-Nigassa, Ben Maacha, Piotin and Fahed. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Guenego, Adrien Khoury, Naim Blanc, Raphaël Mazighi, Mikael Smajda, Stanislas Redjem, Hocine Ciccio, Gabriele Desilles, Jean-Philippe Escalard, Simon Zuber, Kevin Chamard, Pauline Hamdani, Mylène Brikci-Nigassa, Nahida Ben Maacha, Malek Piotin, Michel Fahed, Robert Gadolinium-Enhanced Extracranial MRA Prior to Mechanical Thrombectomy Is Not Associated With an Improved Procedure Speed |
title | Gadolinium-Enhanced Extracranial MRA Prior to Mechanical Thrombectomy Is Not Associated With an Improved Procedure Speed |
title_full | Gadolinium-Enhanced Extracranial MRA Prior to Mechanical Thrombectomy Is Not Associated With an Improved Procedure Speed |
title_fullStr | Gadolinium-Enhanced Extracranial MRA Prior to Mechanical Thrombectomy Is Not Associated With an Improved Procedure Speed |
title_full_unstemmed | Gadolinium-Enhanced Extracranial MRA Prior to Mechanical Thrombectomy Is Not Associated With an Improved Procedure Speed |
title_short | Gadolinium-Enhanced Extracranial MRA Prior to Mechanical Thrombectomy Is Not Associated With an Improved Procedure Speed |
title_sort | gadolinium-enhanced extracranial mra prior to mechanical thrombectomy is not associated with an improved procedure speed |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333645/ https://www.ncbi.nlm.nih.gov/pubmed/30687224 http://dx.doi.org/10.3389/fneur.2018.01171 |
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