Publications by authors named "Anne Dusart"
Background: In the management of acute ischemic stroke with large vessel occlusion (LVO-AIS), current data are conflicting as to whether a mothership model of management (MS) is associated with better functional recovery than a drip-and-ship model (DS).
Method: Files from LVO-AIS patients treated with MT at CHU Charleroi were analyzed between 01/01/2017 and 12/31/2022. Consecutive patients with a LVO-AIS of the anterior circulation and a prestroke modified Rankin Scale (mRS) ≤2 were included.
Article Synopsis
- * Data from 459 patients with vessel perforation showed a 90-day mortality rate of 51.9%, with only 16.3% achieving a favorable recovery (mRS 0-2).
- * The findings indicate that large vessel perforation leads to worse outcomes, while thrombolysis doesn’t worsen prognoses; quick management of bleeding is crucial for survival.
Article Synopsis
- * Data from 670 patients revealed that while IVT may improve some outcomes, such as higher chances of achieving a modified Rankin Scale score of 0-2 in univariable analysis, this benefit was not consistently observed in more rigorous multivariable analyses.
- * Overall, the findings suggest that adjunctive IVT may not significantly enhance clinical outcomes or safety compared to MT alone for this patient population.
Article Synopsis
- Researchers developed a 9-point score to predict positive outcomes for patients undergoing endovascular therapy (EVT) in late-presenting strokes (6-24 hours after last known well), based on a multinational study involving over 3,200 patients.
- The score takes into account factors like age, early CT changes, and stroke severity, with higher scores indicating a better chance of functional recovery at 90 days compared to those receiving only medical management.
- Validation of the score showed it is a useful tool for estimating EVT outcomes, particularly benefiting patients with lower to midrange scores in terms of good functional results and independence.
Article Synopsis
- Mechanical thrombectomy is the standard treatment for large vessel occlusions, but there's limited evidence for its effectiveness in treating distal and medium vessel occlusions, particularly for patients with low stroke scale scores (≤6).
- A study analyzed data from 41 academic centers, comparing outcomes of low versus higher stroke scale score patients who underwent thrombectomy, revealing high successful reperfusion rates in both groups.
- Results showed that patients with lower stroke scale scores experienced better functional outcomes and lower mortality rates, but the treatment's effectiveness compared to intravenous thrombolysis (IVT) is still uncertain.
Background And Purpose: We compared the outcomes of endovascular therapy (EVT) in an extended time window in patients with large-vessel occlusion (LVO) between patients with and without pre-stroke disability.
Methods: In this prespecified analysis of the multinational CT for Late Endovascular Reperfusion study (66 participating sites, 10 countries between 2014 and 2022), we analyzed data from patients with acute ischemic stroke with a pre-stroke modified Rankin Scale (mRS) score of 0-4 and LVO who underwent EVT 6-24 hours from the time last seen well. The primary outcome was the composite of functional independence (FI; mRS score 0-2) or return to the pre-stroke mRS score (return of Rankin, RoR) at 90 days.
Introduction: The benefit of endovascular therapy (EVT) among stroke patients with large ischemic core (ASPECTS 0-5) in the extended time window outside of trial settings remains unclear. We analyzed the effect of EVT among these stroke patients in real-world settings.
Patients And Methods: The CT for Late Endovascular Reperfusion (CLEAR) study recruited patients from 66 centers in 10 countries between 01/2014 and 05/2022.
Background: Studies comparing bridging intravenous thrombolysis (IVT) with direct endovascular therapy (EVT) in patients with acute ischemic stroke who present late are limited. We aimed to compare the clinical outcomes and safety of bridging IVT in patients with acute ischemic stroke due to anterior circulation large vessel occlusion who underwent EVT 6 to 24 hours after time last known well.
Methods: We enrolled patients with anterior circulation large vessel occlusion stroke and a National Institutes of Health Stroke Scale score of ≥6 from 20 centers across 10 countries in the multicenter retrospective CLEAR study (CT for Late Endovascular Reperfusion) between January 2014 and May 2022.
Background And Objectives: There is uncertainty whether patients with large vessel occlusion (LVO) presenting in the late 6-hour to 24-hour time window can be selected for endovascular therapy (EVT) by noncontrast CT (NCCT) and CT angiography (CTA) for LVO detection. We evaluated the clinical outcomes of patients selected for EVT by NCCT compared with those medically managed in the extended time window.
Methods: This multinational cohort study was conducted at 66 sites across 10 countries.
Background: Optimal anesthetic strategy for the endovascular treatment of stroke is still under debate. Despite scarce data concerning anesthetic management for medium and distal vessel occlusions (MeVOs) some centers empirically support a general anesthesia (GA) strategy in these patients.
Methods: We conducted an international retrospective study of MeVO cases.
Background: Mechanical thrombectomy (MT) has revolutionized the treatment of acute ischemic stroke (AIS) due to large vessel occlusion (LVO), but its efficacy and safety in medium vessel occlusion (MeVO) remain less explored. This multicenter, retrospective study aims to investigate the incidence and clinical outcomes of vessel perforations (confirmed by extravasation during an angiographic series) during MT for AIS caused by MeVO.
Methods: Data were collected from 37 academic centers across North America, Asia, and Europe between September 2017 and July 2021.
Article Synopsis
- The study aimed to evaluate the effectiveness and safety of the pRESET LITE stent retriever for treating medium vessel occlusions in acute ischemic stroke patients.
- A retrospective analysis included 227 patients from 37 institutions, distinguishing between proximal and distal occlusions, revealing successful reperfusion rates of 85% and 97%, respectively.
- Despite a 7% complication rate and a significant percentage of patients experiencing hemorrhagic transformations, the procedure showed a favorable outcome in 58% of cases after three months.
Background: The association between sex and outcome after endovascular thrombectomy of acute ischemic stroke is unclear. The aim of this study was to compare the clinical and safety outcomes between men and women treated with endovascular thrombectomy in the late 6-to-24-hour window period.
Methods: This multicenter, retrospective observational cohort study included consecutive patients who underwent endovascular thrombectomy of anterior circulation stroke in the late window from 66 clinical sites in 10 countries from January 2014 to May 2022.
Article Synopsis
- The study investigates the first pass effect (FPE) in endovascular treatment (EVT) for medium vessel occlusion strokes, focusing on its predictors and impact on patient outcomes.
- The analysis included 836 patients, revealing that FPE occurred in 36.1% and was linked to better functional outcomes as well as lower rates of mortality and intracranial hemorrhage.
- FPE was significantly associated with favorable outcomes at 90 days, suggesting its importance in improving recovery and reducing complications in stroke patients.
Objective: Cerebral venous thrombosis (CVT) is a rare condition whose clinical presentation can range from simple headaches to severe impairment of alertness. Some clinical forms, such as involvement of the deep venous system, are associated with a poorer clinical prognosis despite well-managed anticoagulation. The role and timing of rescue mechanical thrombectomy for these patients is not well established.
View Article and Find Full Text PDFBackground And Objectives: COVID-19-related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19.
Methods: This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection.
A worldwide decline in stroke hospitalizations during the COVID-19 pandemic has been reported. Information on stroke care during the pandemic in Belgium is lacking. This study aims to analyze the impact of COVID-19 on acute stroke care in eight Belgian stroke centers.
View Article and Find Full Text PDFObjective: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods.
Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases.
Background: People with intellectual disabilities often present with unique challenges that make it more difficult to meet their palliative care needs.
Aim: To define consensus norms for palliative care of people with intellectual disabilities in Europe.
Design: Delphi study in four rounds: (1) a taskforce of 12 experts from seven European countries drafted the norms, based on available empirical knowledge and regional/national guidelines; (2) using an online survey, 34 experts from 18 European countries evaluated the draft norms, provided feedback and distributed the survey within their professional networks.
Mucormycosis is a rare opportunistic fungal infection. Rhinocerebral form of the disease mainly affects diabetic or immunocompromised patients. Mucormycosis have specific tropism for blood vessels leading to mucorthrombosis and less often to mycotic aneurysms.
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