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de Oliveira F, Léger L, Costalat V, Belhadj I, Pastor M, de Forges H, Beregi JP, Boudemaghe T, Frandon J. Population-based analysis of the number of thrombectomies performed after cerebral ischemic stroke and prognostic factors of mortality in France. Eur J Epidemiol 2024:10.1007/s10654-023-01074-5. [PMID: 38218978 DOI: 10.1007/s10654-023-01074-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/26/2023] [Indexed: 01/15/2024]
Affiliation(s)
- Fabien de Oliveira
- Department of Medical Imaging, IMAGINE UR UM 103, IPI platform, Montpellier University, Nîmes University Hospital, place Prof Robert Debré, 30029, Nîmes Cedex 9, France
| | - Lucas Léger
- UA11 INSERM - UM Institut Desbrest d Épidémiologie et de Santé Publique (IDESP), Montpellier, France
- Department of Medical Information, Methods and Research, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
| | - Vincent Costalat
- Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Ihssen Belhadj
- UA11 INSERM - UM Institut Desbrest d Épidémiologie et de Santé Publique (IDESP), Montpellier, France
- Department of Medical Information, Methods and Research, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
| | - Maxime Pastor
- Department of Medical Imaging, IMAGINE UR UM 103, IPI platform, Montpellier University, Nîmes University Hospital, place Prof Robert Debré, 30029, Nîmes Cedex 9, France
| | - Héléne de Forges
- Department of Medical Imaging, IMAGINE UR UM 103, IPI platform, Montpellier University, Nîmes University Hospital, place Prof Robert Debré, 30029, Nîmes Cedex 9, France
| | - Jean-Paul Beregi
- Department of Medical Imaging, IMAGINE UR UM 103, IPI platform, Montpellier University, Nîmes University Hospital, place Prof Robert Debré, 30029, Nîmes Cedex 9, France
| | - Thierry Boudemaghe
- UA11 INSERM - UM Institut Desbrest d Épidémiologie et de Santé Publique (IDESP), Montpellier, France
- Department of Medical Information, Methods and Research, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
| | - Julien Frandon
- Department of Medical Imaging, IMAGINE UR UM 103, IPI platform, Montpellier University, Nîmes University Hospital, place Prof Robert Debré, 30029, Nîmes Cedex 9, France.
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Olthuis SGH, Hinsenveld WH, Pinckaers FME, Amini M, Lingsma HF, Staals J, HCML Schreuder T, Schonewille WJ, Yo LSF, BWEM Roos Y, Postma AA, Dippel DWJ, van Zwam WH, van Oostenbrugge RJ, de Ridder IR. Association between type of intervention center and outcomes after endovascular treatment for acute ischemic stroke: Results from the MR CLEAN Registry. Eur Stroke J 2022; 8:224-230. [PMID: 37021181 PMCID: PMC10069206 DOI: 10.1177/23969873221145771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Endovascular treatment (EVT) for acute ischemic stroke (AIS) is performed in intervention centers that provide the full range of neuro(endo)vascular care (level 1) and centers that only perform EVT for AIS (level 2). We compared outcomes between these center types and assessed whether differences in outcomes could be explained by center volume (CV). Patients and methods: We analyzed patients included in the MR CLEAN Registry (2014–2018), a registry of all EVT-treated patients in the Netherlands. Our primary outcome was the shift on the modified Rankin scale (mRS) after 90 days (ordinal regression). Secondary outcomes were the NIHSS 24–48 h post-EVT, door-to-groin time (DTGT), procedure time (linear regression), and recanalization (binary logistic regression). We compared outcomes between level 1 and 2 centers using multilevel regression models, with center as random intercept. We adjusted for relevant baseline factors, and in case of observed differences, we additionally adjusted for CV. Results: Of the 5144 patients 62% were treated in level 1 centers. We observed no significant differences between center types in mRS (adjusted(a)cOR: 0.79, 95% CI: 0.40 to 1.54), NIHSS (aβ: 0.31, 95% CI: −0.52 to 1.14), procedure duration (aβ: 0.88, 95% CI: −5.21 to 6.97), or DTGT (aβ: 4.24, 95% CI: −7.09 to 15.57). The probability for recanalization was higher in level 1 centers compared to level 2 centers (aOR 1.60, 95% CI: 1.10 to 2.33), and this difference probably depended on CV. Conclusions: We found no significant differences, that were independent of CV, in the outcomes of EVT for AIS between level 1 and level 2 intervention centers.
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Affiliation(s)
- Susanne GH Olthuis
- Department of Neurology, Maastricht University Medical Centre and School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
| | - Wouter H Hinsenveld
- Department of Neurology, Maastricht University Medical Centre and School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
| | - Florentina ME Pinckaers
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre and School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
| | - Marzyeh Amini
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Hester F Lingsma
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Centre and School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
| | | | | | - Lonneke SF Yo
- Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Yvo BWEM Roos
- Department of Neurology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Alida A Postma
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre and School for Mental Health and Sciences (MheNS), Maastricht, The Netherlands
| | - Diederik WJ Dippel
- Department of Neurology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Wim H van Zwam
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre and School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
| | - Robert J van Oostenbrugge
- Department of Neurology, Maastricht University Medical Centre and School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
| | - Inger R de Ridder
- Department of Neurology, Maastricht University Medical Centre and School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
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Commentary on "Outcomes of Stroke Thrombectomy Performed by Interventional Radiologists versus Neurointerventional Physicians". J Vasc Interv Radiol 2022; 33:627-630. [PMID: 35636832 DOI: 10.1016/j.jvir.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/16/2022] [Accepted: 04/01/2022] [Indexed: 11/20/2022] Open
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