1.Bilateral optic neuropathy related to severe anemia in a patient with alcoholic cirrhosis: A case report and review of the literature.
Lisa HUMBERTJEAN-SELTON ; Jérôme SELTON ; Nolwenn RIOU-COMTE ; Jean Christophe LACOUR ; Gioia MIONE ; Sébastien RICHARD
Clinical and Molecular Hepatology 2018;24(4):417-423
Anemia appears frequently in patients with alcoholic liver disease (ALD) but has never been linked to bilateral nonarteritic anterior ischemic optic neuropathy (NAION). A 65-year-old woman with a medical history of alcoholic cirrhosis was admitted for bilateral NAION. On admission, she was found to have a low arterial pressure and severe normocytic anemia (48 g/L). The anemia was related to chronic bleeding due to antral gastritis along with other factors associated with ALD. The applied treatment consisted of urgent transfusion followed by high doses of proton-pump inhibitors, iron and vitamin supplementation, and support in lifestyle measures. Her hemoglobin levels remained stable after 2 years but the patient still suffered from visual loss. This case highlights the link between anemia and bilateral NAION in ALD patients. The optic nerve head is prone to infarction in this context due to the vascularization characteristics of ALD. Hemoglobin levels should be monitored in ALD patients to avoid the severe complication of NAION.
Aged
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Alcoholics*
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Anemia*
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Arterial Pressure
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Female
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Gastritis
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Hemorrhage
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Humans
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Infarction
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Iron
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Life Style
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Liver Cirrhosis, Alcoholic*
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Liver Diseases, Alcoholic
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Optic Disk
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Optic Nerve Diseases*
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Optic Neuropathy, Ischemic
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Vitamins
2.Endovascular Treatment of Distal-M2 Segment Occlusions: A Clinical Registry and Meta-Analysis
Sacha BENSOUSSAN ; Stephanos Nikolaos FINITSIS ; Bertrand LAPERGUE ; Gaultier MARNAT ; Igor SIBON ; Solène MOULIN ; Jean-Marc OLIVOT ; Sébastien RICHARD ; Charlotte ROSSO ; Benjamin GORY ; Frédéric CLARENÇON ;
Journal of Stroke 2023;25(2):299-302
3.Thrombolysis Improves Reperfusion and the Clinical Outcome in Tandem Occlusion Stroke Related to Cervical Dissection: TITAN and ETIS Pooled Analysis
Gaultier MARNAT ; Igor SIBON ; Romain BOURCIER ; Mohammad ANADANI ; Florent GARIEL ; Julien LABREUCHE ; Maeva KYHENG ; Mikael MAZIGHI ; Cyril DARGAZANLI ; Michel PIOTIN ; Arturo CONSOLI ; Raphaël BLANC ; René ANXIONNAT ; Gérard AUDIBERT ; Sébastien RICHARD ; Bertrand LAPERGUE ; Benjamin GORY ;
Journal of Stroke 2021;23(3):411-419
Background:
and Purpose Despite the widespread adoption of mechanical thrombectomy (MT) for the treatment of large vessel occlusion stroke (LVOS) in the anterior circulation, the optimal strategy for the treatment tandem occlusion related to cervical internal carotid artery (ICA) dissection is still debated. This individual patient pooled analysis investigated the safety and efficacy of prior intravenous thrombolysis (IVT) in anterior circulation tandem occlusion related to cervical ICA dissection treated with MT.
Methods:
We performed a retrospective analysis of two merged prospective multicenter international real-world observational registries: Endovascular Treatment in Ischemic Stroke (ETIS) and Thrombectomy In TANdem occlusions (TITAN) registries. Data from MT performed in the treatment of tandem LVOS related to cervical ICA dissection between January 2012 and December 2019 at 24 comprehensive stroke centers were analyzed. The primary endpoint was a favorable outcome defined as 90-day modified Rankin Scale (mRS) score of 0–2.
Results:
The study included 144 patients with tandem occlusion LVOS due to cervical ICA dissection, of whom 94 (65.3%) received IVT before MT. Prior IVT was significantly associated with a better clinical outcome considering the mRS shift analysis (common odds ratio, 2.59; 95% confidence interval [CI], 1.35 to 4.93; P=0.004 for a 1-point improvement) and excellent outcome (90-day mRS 0–1) (adjusted odds ratio [aOR], 4.23; 95% CI, 1.60 to 11.18). IVT was also associated with a higher rate of intracranial successful reperfusion (83.0% vs. 64.0%; aOR, 2.70; 95% CI, 1.21 to 6.03) and a lower rate of symptomatic intracranial hemorrhage (4.3% vs. 14.8%; aOR, 0.21; 95% CI, 0.05 to 0.80).
Conclusions
Prior IVT before MT for the treatment of tandem occlusion related to cervical ICA dissection was safe and associated with an improved 90-day functional outcome.
4.Thrombolysis Improves Reperfusion and the Clinical Outcome in Tandem Occlusion Stroke Related to Cervical Dissection: TITAN and ETIS Pooled Analysis
Gaultier MARNAT ; Igor SIBON ; Romain BOURCIER ; Mohammad ANADANI ; Florent GARIEL ; Julien LABREUCHE ; Maeva KYHENG ; Mikael MAZIGHI ; Cyril DARGAZANLI ; Michel PIOTIN ; Arturo CONSOLI ; Raphaël BLANC ; René ANXIONNAT ; Gérard AUDIBERT ; Sébastien RICHARD ; Bertrand LAPERGUE ; Benjamin GORY ;
Journal of Stroke 2021;23(3):411-419
Background:
and Purpose Despite the widespread adoption of mechanical thrombectomy (MT) for the treatment of large vessel occlusion stroke (LVOS) in the anterior circulation, the optimal strategy for the treatment tandem occlusion related to cervical internal carotid artery (ICA) dissection is still debated. This individual patient pooled analysis investigated the safety and efficacy of prior intravenous thrombolysis (IVT) in anterior circulation tandem occlusion related to cervical ICA dissection treated with MT.
Methods:
We performed a retrospective analysis of two merged prospective multicenter international real-world observational registries: Endovascular Treatment in Ischemic Stroke (ETIS) and Thrombectomy In TANdem occlusions (TITAN) registries. Data from MT performed in the treatment of tandem LVOS related to cervical ICA dissection between January 2012 and December 2019 at 24 comprehensive stroke centers were analyzed. The primary endpoint was a favorable outcome defined as 90-day modified Rankin Scale (mRS) score of 0–2.
Results:
The study included 144 patients with tandem occlusion LVOS due to cervical ICA dissection, of whom 94 (65.3%) received IVT before MT. Prior IVT was significantly associated with a better clinical outcome considering the mRS shift analysis (common odds ratio, 2.59; 95% confidence interval [CI], 1.35 to 4.93; P=0.004 for a 1-point improvement) and excellent outcome (90-day mRS 0–1) (adjusted odds ratio [aOR], 4.23; 95% CI, 1.60 to 11.18). IVT was also associated with a higher rate of intracranial successful reperfusion (83.0% vs. 64.0%; aOR, 2.70; 95% CI, 1.21 to 6.03) and a lower rate of symptomatic intracranial hemorrhage (4.3% vs. 14.8%; aOR, 0.21; 95% CI, 0.05 to 0.80).
Conclusions
Prior IVT before MT for the treatment of tandem occlusion related to cervical ICA dissection was safe and associated with an improved 90-day functional outcome.
5.Recanalization before Thrombectomy in Tenecteplase vs. Alteplase-Treated Drip-and-Ship Patients
Pierre SENERS ; Jildaz CAROFF ; Nicolas CHAUSSON ; Guillaume TURC ; Christian DENIER ; Michel PIOTIN ; Manvel AGHASARYAN ; Cosmin ALECU ; Olivier CHASSIN ; Bertrand LAPERGUE ; Olivier NAGGARA ; Marc FERRIGNO ; Caroline ARQUIZAN ; Tae Hee CHO ; Ana Paula NARATA ; Sébastien RICHARD ; Nicolas BRICOUT ; Mikaël MAZIGHI ; Vincent COSTALAT ; Benjamin GORY ; Séverine DEBIAIS ; Arturo CONSOLI ; Serge BRACARD ; Catherine OPPENHEIM ; Jean Louis MAS ; Didier SMADJA ; Laurent SPELLE ; Jean Claude BARON
Journal of Stroke 2019;21(1):105-107
No abstract available.
Humans
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Thrombectomy