João Pedro Marto, Christoph Riegler, Pimrapat Gebert, Tilman Reiff, Marek Sykora, Marcin Wiącek, David Pakizer, André Araújo, Adrien Ter Schiphorst, João André Sousa, Arno Reich, Belen Flores Pina, Lukas Mayer-Suess, Cristina Hobeanu, Marialuisa Zedde, João Nuno Ramos, Georgios Tsivgoulis, Pedro Castro, Sven Poli, José Nuno Alves, Anne Dusart, Blanca Fuentes, Herbert Tejada Meza, Jelle Demeestere, Susanne Wegener, Lars Kellert, Patricia Calleja, Cristina Panea, Christoph Vollmuth, Liliana Pereira, Ronen R Leker, Timo Uphaus, Andrea Zini, Henrik Gensicke, Gauthier Duloquin, Taraneh Ebrahimi, Alexander Salerno, Cristina Tiu, Thanh N Nguyen, Sebastian García-Madrona, Marta Bilik, Shadi Yaghi, Halina Sienkiewicz-Jarosz, Michał Karliński, Stefan Krebs, Eva Hurtíková, Nathalia Ferreira, João Sargento-Freitas, João Pinho, Isabel Rodriguez Caamaño, Elke Ruth Gizewski, Pierre Seners, Rosario Pascarella, Klearchos Psychogios, Alexandra Gomez Exposito, Sara Gomes, Flavio Bellante, Jorge Rodríguez-Pardo, Mario Bautista Lacambra, Robin Lemmens, Corinne Inauen, Johannes Wischmann, Fernando Ostos, Vlad Tiu, Karl Georg Haeusler, Miguel Rodrigues, Issa Metanis, Marianne Hahn, Maria Maddalena Viola, Simon Truessel, Yannick Bejot, Louisa Nitsch, Davide Strambo, Elena Oana Terecoasa, Mohamad Abdalkader, Alicia de Felipe, Farhan Khan, Caroline Arquizan, Manuel Ribeiro, Martin Roubec, Izabella Tomaszewska-Lampart, Julia Ferrari, Peter Ringleb, Christian H Nolte
{"title":"血管内治疗孤立性颈内动脉闭塞：ETIICA研究。","authors":"João Pedro Marto, Christoph Riegler, Pimrapat Gebert, Tilman Reiff, Marek Sykora, Marcin Wiącek, David Pakizer, André Araújo, Adrien Ter Schiphorst, João André Sousa, Arno Reich, Belen Flores Pina, Lukas Mayer-Suess, Cristina Hobeanu, Marialuisa Zedde, João Nuno Ramos, Georgios Tsivgoulis, Pedro Castro, Sven Poli, José Nuno Alves, Anne Dusart, Blanca Fuentes, Herbert Tejada Meza, Jelle Demeestere, Susanne Wegener, Lars Kellert, Patricia Calleja, Cristina Panea, Christoph Vollmuth, Liliana Pereira, Ronen R Leker, Timo Uphaus, Andrea Zini, Henrik Gensicke, Gauthier Duloquin, Taraneh Ebrahimi, Alexander Salerno, Cristina Tiu, Thanh N Nguyen, Sebastian García-Madrona, Marta Bilik, Shadi Yaghi, Halina Sienkiewicz-Jarosz, Michał Karliński, Stefan Krebs, Eva Hurtíková, Nathalia Ferreira, João Sargento-Freitas, João Pinho, Isabel Rodriguez Caamaño, Elke Ruth Gizewski, Pierre Seners, Rosario Pascarella, Klearchos Psychogios, Alexandra Gomez Exposito, Sara Gomes, Flavio Bellante, Jorge Rodríguez-Pardo, Mario Bautista Lacambra, Robin Lemmens, Corinne Inauen, Johannes Wischmann, Fernando Ostos, Vlad Tiu, Karl Georg Haeusler, Miguel Rodrigues, Issa Metanis, Marianne Hahn, Maria Maddalena Viola, Simon Truessel, Yannick Bejot, Louisa Nitsch, Davide Strambo, Elena Oana Terecoasa, Mohamad Abdalkader, Alicia de Felipe, Farhan Khan, Caroline Arquizan, Manuel Ribeiro, Martin Roubec, Izabella Tomaszewska-Lampart, Julia Ferrari, Peter Ringleb, Christian H Nolte","doi":"10.1177/23969873251323488","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Evidence regarding the benefit of endovascular therapy (EVT) in patients with acute ischemic stroke (AIS) due to isolated cervical internal carotid artery occlusion (c-ICA-O) is lacking. We assessed the outcomes and safety of EVT in patients with isolated c-ICA-O.</p><p><strong>Methods: </strong>Retrospective multicenter cohort study of patients with an AIS due to isolated c-ICA-O, within 24-h since last-seen-well. Comparisons were made between EVT and best medical therapy (BMT). The primary outcome was 3-months modified Rankin Scale (mRS) ordinal shift. Secondary outcomes included 3-month favorable outcome (mRS 0-2, or return to pre-stroke mRS), symptomatic intracranial hemorrhage (sICH) and any parenchymal hemorrhage. Outcomes were compared combining inverse probability of treatment weighting with regression models and propensity score matching (PSM) as sensitivity analysis.</p><p><strong>Results: </strong>We analyzed 998 patients (66.2% male, mean age 71.1 ± 13.2 years). 487 (48.8%) patients received EVT and 511 (51.2%) received BMT. Patients receiving EVT had a higher admission NIHSS [13 (7-18) vs 5 (2-13)] compared to BMT. There was no difference between EVT and BMT groups in 3-month mRS shift (adjusted common odds ratio [OR], 1.01 [95% CI 0.76-1.34]) and favorable outcome (adjusted OR [aOR] 1.16 [95% CI 0.84-1.60]). No patient (0%) in the BMT group had sICH versus 1.6% in the EVT group. Parenchymal hemorrhage was numerically higher in EVT patients (2.7% vs 0.6%; aOR 3.85 [95% CI 0.98-15.23]). PSM analysis revealed similar results.</p><p><strong>Discussion and conclusion: </strong>In patients with isolated c-ICA-O, EVT was associated with similar odds of disability and intracranial bleeding compared to BMT. Randomized-controlled clinical trials in patients with isolated c-ICA-O are warranted.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"23969873251323488"},"PeriodicalIF":5.8000,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869225/pdf/","citationCount":"0","resultStr":"{\"title\":\"Endovascular treatment for isolated cervical internal carotid artery occlusion: ETIICA study.\",\"authors\":\"João Pedro Marto, Christoph Riegler, Pimrapat Gebert, Tilman Reiff, Marek Sykora, Marcin Wiącek, David Pakizer, André Araújo, Adrien Ter Schiphorst, João André Sousa, Arno Reich, Belen Flores Pina, Lukas Mayer-Suess, Cristina Hobeanu, Marialuisa Zedde, João Nuno Ramos, Georgios Tsivgoulis, Pedro Castro, Sven Poli, José Nuno Alves, Anne Dusart, Blanca Fuentes, Herbert Tejada Meza, Jelle Demeestere, Susanne Wegener, Lars Kellert, Patricia Calleja, Cristina Panea, Christoph Vollmuth, Liliana Pereira, Ronen R Leker, Timo Uphaus, Andrea Zini, Henrik Gensicke, Gauthier Duloquin, Taraneh Ebrahimi, Alexander Salerno, Cristina Tiu, Thanh N Nguyen, Sebastian García-Madrona, Marta Bilik, Shadi Yaghi, Halina Sienkiewicz-Jarosz, Michał Karliński, Stefan Krebs, Eva Hurtíková, Nathalia Ferreira, João Sargento-Freitas, João Pinho, Isabel Rodriguez Caamaño, Elke Ruth Gizewski, Pierre Seners, Rosario Pascarella, Klearchos Psychogios, Alexandra Gomez Exposito, Sara Gomes, Flavio Bellante, Jorge Rodríguez-Pardo, Mario Bautista Lacambra, Robin Lemmens, Corinne Inauen, Johannes Wischmann, Fernando Ostos, Vlad Tiu, Karl Georg Haeusler, Miguel Rodrigues, Issa Metanis, Marianne Hahn, Maria Maddalena Viola, Simon Truessel, Yannick Bejot, Louisa Nitsch, Davide Strambo, Elena Oana Terecoasa, Mohamad Abdalkader, Alicia de Felipe, Farhan Khan, Caroline Arquizan, Manuel Ribeiro, Martin Roubec, Izabella Tomaszewska-Lampart, Julia Ferrari, Peter Ringleb, Christian H Nolte\",\"doi\":\"10.1177/23969873251323488\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Evidence regarding the benefit of endovascular therapy (EVT) in patients with acute ischemic stroke (AIS) due to isolated cervical internal carotid artery occlusion (c-ICA-O) is lacking. 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There was no difference between EVT and BMT groups in 3-month mRS shift (adjusted common odds ratio [OR], 1.01 [95% CI 0.76-1.34]) and favorable outcome (adjusted OR [aOR] 1.16 [95% CI 0.84-1.60]). No patient (0%) in the BMT group had sICH versus 1.6% in the EVT group. Parenchymal hemorrhage was numerically higher in EVT patients (2.7% vs 0.6%; aOR 3.85 [95% CI 0.98-15.23]). PSM analysis revealed similar results.</p><p><strong>Discussion and conclusion: </strong>In patients with isolated c-ICA-O, EVT was associated with similar odds of disability and intracranial bleeding compared to BMT. 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引用次数: 0
摘要
关于血管内治疗（EVT）对孤立性颈内动脉闭塞（c-ICA-O）急性缺血性卒中（AIS）患者的益处的证据缺乏。我们评估了孤立性c-ICA-O患者EVT的结果和安全性。方法：对离体c-ICA-O引起的AIS患者进行回顾性多中心队列研究，时间为最后一次见井后24小时内。EVT与最佳药物治疗（best medical therapy， BMT）进行比较。主要观察指标为3个月修正Rankin量表（mRS）的顺序变化。次要结果包括3个月的良好结果（mRS 0-2，或恢复到卒中前mRS），症状性颅内出血（sICH）和任何实质出血。将治疗加权逆概率与回归模型和倾向评分匹配（PSM）作为敏感性分析，对结果进行比较。结果：998例患者中，男性占66.2%，平均年龄71.1±13.2岁。EVT患者487例（48.8%），BMT患者511例（51.2%）。与BMT相比，接受EVT的患者入院NIHSS更高[13 (7-18)vs 5(2-13)]。EVT组和BMT组在3个月mRS变化（调整后的共同优势比[OR]为1.01 [95% CI 0.76-1.34]）和良好预后（调整后的OR [aOR]为1.16 [95% CI 0.84-1.60]）方面无差异。BMT组无患者（0%）发生sICH， EVT组为1.6%。EVT患者的实质出血数量更高(2.7% vs 0.6%；aOR 3.85 [95% CI 0.98-15.23])。PSM分析显示了类似的结果。讨论和结论：与BMT相比，在孤立性c-ICA-O患者中，EVT与致残和颅内出血的几率相似。对孤立性c-ICA-O患者进行随机对照临床试验是有必要的。
Introduction: Evidence regarding the benefit of endovascular therapy (EVT) in patients with acute ischemic stroke (AIS) due to isolated cervical internal carotid artery occlusion (c-ICA-O) is lacking. We assessed the outcomes and safety of EVT in patients with isolated c-ICA-O.
Methods: Retrospective multicenter cohort study of patients with an AIS due to isolated c-ICA-O, within 24-h since last-seen-well. Comparisons were made between EVT and best medical therapy (BMT). The primary outcome was 3-months modified Rankin Scale (mRS) ordinal shift. Secondary outcomes included 3-month favorable outcome (mRS 0-2, or return to pre-stroke mRS), symptomatic intracranial hemorrhage (sICH) and any parenchymal hemorrhage. Outcomes were compared combining inverse probability of treatment weighting with regression models and propensity score matching (PSM) as sensitivity analysis.
Results: We analyzed 998 patients (66.2% male, mean age 71.1 ± 13.2 years). 487 (48.8%) patients received EVT and 511 (51.2%) received BMT. Patients receiving EVT had a higher admission NIHSS [13 (7-18) vs 5 (2-13)] compared to BMT. There was no difference between EVT and BMT groups in 3-month mRS shift (adjusted common odds ratio [OR], 1.01 [95% CI 0.76-1.34]) and favorable outcome (adjusted OR [aOR] 1.16 [95% CI 0.84-1.60]). No patient (0%) in the BMT group had sICH versus 1.6% in the EVT group. Parenchymal hemorrhage was numerically higher in EVT patients (2.7% vs 0.6%; aOR 3.85 [95% CI 0.98-15.23]). PSM analysis revealed similar results.
Discussion and conclusion: In patients with isolated c-ICA-O, EVT was associated with similar odds of disability and intracranial bleeding compared to BMT. Randomized-controlled clinical trials in patients with isolated c-ICA-O are warranted.
期刊介绍：
Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.
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