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Artery occlusion independently predicts unfavorable outcome in cervical artery dissection

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 Di...

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Main Authors: Tränka, Christopher (Author) , Grond-Ginsbach, Caspar (Author) , Goeggel Simonetti, Barbara (Author) , Metso, Tiina M. (Author) , Debette, Stéphanie (Author) , Pezzini, Alessandro (Author) , Kloss, Manja (Author) , Majersik, Jennifer J. (Author) , Southerland, Andrew M. (Author) , Leys, Didier (Author) , Baumgartner, Ralf (Author) , Caso, Valeria (Author) , Béjot, Yannick (Author) , De Marchis, Gian Marco (Author) , Fischer, Urs (Author) , Polymeris, Alexandros (Author) , Sarikaya, Hakan (Author) , Thijs, Vincent (Author) , Worrall, Bradford B. (Author) , Bersano, Anna (Author) , Brandt, Tobias (Author) , Gensicke, Henrik (Author) , Bonati, Leo H. (Author) , Touzeé, Emmanuel (Author) , Martin, Juan J. (Author) , Chabriat, Hugues (Author) , Tatlisumak, Turgut (Author) , Arnold, Marcel (Author) , Engelter, Stefan T. (Author) , Lyrer, Philippe (Author)
Format: Article (Journal)
Language:English
Published: 2020
In: Neurology
Year: 2019, Volume: 94, Issue: 2, Pages: e170-e180
ISSN:1526-632X
DOI:10.1212/WNL.0000000000008654
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1212/WNL.0000000000008654
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Author Notes: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

MARC

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245 1 0 |a Artery occlusion independently predicts unfavorable outcome in cervical artery dissection  |c 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 
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500 |a First published November 22, 2019 
500 |a Gesehen am 29.06.2020 
520 |a 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. 
534 |c 2019 
650 4 |a Adult 
650 4 |a Aged 
650 4 |a Aneurysm, Dissecting 
650 4 |a Cerebral Arterial Diseases 
650 4 |a Cerebrovascular Disorders 
650 4 |a Female 
650 4 |a Humans 
650 4 |a Male 
650 4 |a Middle Aged 
650 4 |a Recovery of Function 
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