Tags

Type your tag names separated by a space and hit enter

Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19: Experience From Paris.
Stroke. 2020 08; 51(8):2540-2543.S

Abstract

BACKGROUND AND PURPOSE

Higher rates of strokes have been observed in patients with coronavirus disease 2019 (COVID-19), but data regarding the outcomes of COVID-19 patients suffering from acute ischemic stroke due to large vessel occlusion (LVO) are lacking. We report our initial experience in the treatment of acute ischemic stroke with LVO in patients with COVID-19.

METHODS

All consecutive patients with COVID-19 with acute ischemic stroke due to LVO treated in our institution during the 6 first weeks of the COVID-19 outbreak were included. Baseline clinical and radiological findings, treatment, and short-term outcomes are reported.

RESULTS

We identified 10 patients with confirmed COVID-19 treated for an acute ischemic stroke due to LVO. Eight were men, with a median age of 59.5 years. Seven had none or mild symptoms of COVID-19 at stroke onset. Median time from COVID-19 symptoms to stroke onset was 6 days. All patients had brain imaging within 3 hours from symptoms onset. Five patients had multi-territory LVO. Five received intravenous alteplase. All patients had mechanical thrombectomy. Nine patients achieved successful recanalization (mTICI2B-3), none experienced early neurological improvement, 4 had early cerebral reocclusion, and a total of 6 patients (60%) died in the hospital.

CONCLUSIONS

Best medical care including early intravenous thrombolysis, and successful and prompt recanalization achieved with mechanical thrombectomy, resulted in poor outcomes in patients with COVID-19. Although our results require further confirmation, a different pharmacological approach (antiplatelet or other) should be investigated to take in account inflammatory and coagulation disorders associated with COVID-19.

Authors+Show Affiliations

From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32466736

Citation

Escalard, Simon, et al. "Treatment of Acute Ischemic Stroke Due to Large Vessel Occlusion With COVID-19: Experience From Paris." Stroke, vol. 51, no. 8, 2020, pp. 2540-2543.
Escalard S, Maïer B, Redjem H, et al. Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19: Experience From Paris. Stroke. 2020;51(8):2540-2543.
Escalard, S., Maïer, B., Redjem, H., Delvoye, F., Hébert, S., Smajda, S., Ciccio, G., Desilles, J. P., Mazighi, M., Blanc, R., & Piotin, M. (2020). Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19: Experience From Paris. Stroke, 51(8), 2540-2543. https://doi.org/10.1161/STROKEAHA.120.030574
Escalard S, et al. Treatment of Acute Ischemic Stroke Due to Large Vessel Occlusion With COVID-19: Experience From Paris. Stroke. 2020;51(8):2540-2543. PubMed PMID: 32466736.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19: Experience From Paris. AU - Escalard,Simon, AU - Maïer,Benjamin, AU - Redjem,Hocine, AU - Delvoye,François, AU - Hébert,Solène, AU - Smajda,Stanislas, AU - Ciccio,Gabriele, AU - Desilles,Jean-Philippe, AU - Mazighi,Mikael, AU - Blanc,Raphael, AU - Piotin,Michel, Y1 - 2020/05/29/ PY - 2020/5/30/pubmed PY - 2020/8/7/medline PY - 2020/5/30/entrez KW - COVID-19 KW - coagulation disorder KW - outbreak KW - stroke KW - thrombectomy SP - 2540 EP - 2543 JF - Stroke JO - Stroke VL - 51 IS - 8 N2 - BACKGROUND AND PURPOSE: Higher rates of strokes have been observed in patients with coronavirus disease 2019 (COVID-19), but data regarding the outcomes of COVID-19 patients suffering from acute ischemic stroke due to large vessel occlusion (LVO) are lacking. We report our initial experience in the treatment of acute ischemic stroke with LVO in patients with COVID-19. METHODS: All consecutive patients with COVID-19 with acute ischemic stroke due to LVO treated in our institution during the 6 first weeks of the COVID-19 outbreak were included. Baseline clinical and radiological findings, treatment, and short-term outcomes are reported. RESULTS: We identified 10 patients with confirmed COVID-19 treated for an acute ischemic stroke due to LVO. Eight were men, with a median age of 59.5 years. Seven had none or mild symptoms of COVID-19 at stroke onset. Median time from COVID-19 symptoms to stroke onset was 6 days. All patients had brain imaging within 3 hours from symptoms onset. Five patients had multi-territory LVO. Five received intravenous alteplase. All patients had mechanical thrombectomy. Nine patients achieved successful recanalization (mTICI2B-3), none experienced early neurological improvement, 4 had early cerebral reocclusion, and a total of 6 patients (60%) died in the hospital. CONCLUSIONS: Best medical care including early intravenous thrombolysis, and successful and prompt recanalization achieved with mechanical thrombectomy, resulted in poor outcomes in patients with COVID-19. Although our results require further confirmation, a different pharmacological approach (antiplatelet or other) should be investigated to take in account inflammatory and coagulation disorders associated with COVID-19. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/32466736/Treatment_of_Acute_Ischemic_Stroke_due_to_Large_Vessel_Occlusion_With_COVID_19:_Experience_From_Paris_ L2 - https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.030574?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -