Recanalization After Acute Cervical Artery Dissection: A Multicenter International Study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Romoli Michele, Muppa Jayachandra, Lee Elizabeth M, Mandel Daniel M, Kam Wayneho, Mac Grory Brian, Zubair Adeel S, ElNazeir Marwa, Frontera Jennifer A, Salehi Omran Setareh, Saleh Velez Faddi G, Rothstein Aaron, Khazaal Ossama, Ghannam Malik, Almajali Mohammad, Samaniego Edgar A, Bavarsad Shahripour Reza, Al Kasab Sami, Fonseca Ana Catarina, Heldner Mirjam Rachel, Antonenko Kateryna, De Marco Giovanna, Longoni Marco, Faini Claudia, Tudisco Valentina, Zedde Marialuisa, Pascarella Rosario, Marto João Pedro, Sousa João André, Botelho Rosa Sara, Nunes Ana Paiva, Aguiar De Sousa Diana, Nehme Ahmad, Shu Liqi, Yaghi Shadi, Henninger Nils
Аннотация
METHODS: This was a planned subanalysis of the Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection study, a multicenter retrospective cohort including patients with imaging-confirmed CeAD diagnosed between January 2015 and June 2022 at 63 sites worldwide. For this analysis, we included 1,095 patients with single-vessel CeAD causing stenosis at presentation who had available follow-up vascular imaging at 6 months after CeAD. The primary outcome was complete recanalization within 6 months after CeAD. Clinical and imaging variables, as well as recurrent stroke, were compared between patients with and those without complete recanalization. Factors independently associated with complete recanalization were identified using multivariable logistic regression. Time to complete recanalization was analyzed using an accelerated failure time Weibull model.
RESULTS: Among 1,095 included patients (median age 45 years; 46.7% female), 634 (57.9%) achieved complete recanalization by 6 months. In multivariable analysis, each additional year of age was associated with lower odds of complete recanalization (odds ratio [OR] 0.97 per year; 95% CI 0.96-0.98; p < 0.001). Diabetes (OR 0.46; 95% CI 0.27-0.81; p = 0.006), active smoking (OR 0.69; 95% CI 0.50-0.95; p = 0.025), and complete occlusion at presentation (OR 0.44; 95% CI 0.32-0.59; p < 0.001) were independently associated with lower odds of complete recanalization. Complete occlusion at presentation was associated with both longer time to, and lower rates of, complete recanalization. We observed no effect of antithrombotic regimen (antiplatelet therapy vs anticoagulation) on complete recanalization. Incomplete recanalization was associated with a nonsignificant numerically higher proportion of recurrent stroke (5.4% vs 3.5%; p = 0.064).
DISCUSSION: Almost 60% of patients with CeAD achieved complete vessel recanalization by 6 months. Older age, diabetes, smoking, and complete occlusion at presentation were independently associated with incomplete recanalization. Further study is required to determine whether these findings may help guide tailored imaging surveillance and secondary prevention strategies.