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International audience; The Social and Cognitive Evaluation Battery (SCEB) is an instrument specifically created for the examination of pre-school and school-aged children with autism and intellectual disability and recommended by the French High Health Authority (HAS, 2010, 2011, 2012, 2018). The SCEB explores 16 functional abilities, in both cognitive and socio-emotional areas and allows the calculation of domains and areas developmental levels and heterogeneity indices for the global, cognitive and socio-emotional areas. Each of the 16 domains of the SCEB includes behavioral items hierarchized into 4 developmental levels corresponding to 4 age periods (level 1: 4–8 months; level 2: 8–12 months; level 3: 12–18 months; level 4: 18–24 months). The child's assessment provides a profile of the 16 levels of cognitive and socio-emotional development that can be interpreted within the framework of Piaget's (1977) and Fisher's (1980) theory. The study tests the developmental sensitivity of level scores and their adjustment to chronological ages and developmental ages assessed with the Brunet-Lézine Scale for 65 young typical developmental French children aged from 4 months to 24 months. The results show high sensitivity of scores and satisfactory adjustment to chronological and developmental age differences. Normative benchmarks are also given for indices of heterogeneity of development profiles, heterogeneity that decreases with age. Thus, the scores are interpretable in reference to theoretical models and can be used for the study of all developmental characteristics in infant and toddlers’ children with and without neurodevelopmental disorder.; La Batterie d’Évaluation du développement Cognitif et Social (BECS) a été construite pour évaluer le développement de seize capacités chez des enfants ayant un trouble du spectre de l’autisme et un handicap intellectuel. Chacun des domaines de la BECS comprend des items hiérarchisés en 4 niveaux de développement correspondant à 4 périodes d’âges (1 : 4–8 mois ; 2 : 8–12 mois ; 3 : 12–18 mois ; 4 : 18–24 mois). Le profil des 16 niveaux de développement est interprétable dans le cadre de la théorie de Piaget (1977) et de celle de Fischer (1980). L’étude teste la sensibilité développementale des scores de niveaux et leur ajustement aux âges chronologiques pour 65 jeunes enfants au développement typique. Les résultats montrent une sensibilité élevée des scores et un ajustement satisfaisant aux différences d’âges chronologiques. Les scores sont interprétables en référence aux modèles théoriques et utilisables pour l’étude de toutes particularités développementales.

International audience; Endovascular interventions are experiencing an important development. Despite many advantages of this type of intervention, catheter navigation is still a cause of difficulties or failure. Mechanical thrombectomy is one of these interventions where navigation difficulties are related to the ability to navigate the aortic arch and access the carotid. These difficulties are due to the selection of adequate catheters and guides for a specific anatomy and to the technical gesture to operate. The objective of this work is to propose a method to find similar endovascular navigation paths from pre-existing patients to support intervention in mechanical thrombectomy. For each patient, iso-centerlines of the aortic arch and supra-aortic trunks are extracted from pre-operative magnetic resonance angiography volume. A statistical shape model is computed from these vascular structure iso-centerlines. Euclidean distance between vectors of statistical shape model modes is used to compare endovascular navigation paths. A set of 6 patient cases was used to compute the statistical shape model. For validation, an additional set of 5 patient cases was considered to generate new iso-centerlines.Retrieval of closest iso-centerlines were correct in more than 95% of cases with the proposed method while this percentage goes down to 43% with Euclidean distance between 3D points of iso-centerlines.Clinical relevance - The presented method allows physicians to retrieve past navigation paths similar to a new one. Used in planning, this could allow to anticipate navigation difficulties in mechanical thrombectomy. © 2021 IEEE.

Background: Endovascular therapy (EVT) is effective and safe in patients with tandem occlusion. The benefit of intravenous thrombolysis (IVT) prior to EVT in acute tandem occlusion is debatable. Objective: To compare EVT alone with EVT plus IVT in patients with acute ischemic stroke due to anterior circulation tandem occlusions. Methods: This is an individual patient pooled analysis of the Thrombectomy In TANdem lesions (TITAN) and Endovascular Treatment in Ischemic Stroke (ETIS) Registries. Patients were divided into two groups based on prior IVT treatment: (1) IVT+ group, which included patients who received IVT prior to EVT, (2) IVT- group, which included patients who did not receive IVT prior to EVT. Propensity score (inverse probability of treatment weighting (IPTW)) was used to reduce baseline between-group differences. The primary outcome was favorable outcome - that is, modified Rankin Scale (mRS) score 0 to 2 at 90 days. Results: Overall, 602 consecutive patients with an acute stroke with tandem occlusion were included (380 and 222 in the bridging therapy and EVT alone groups, respectively). Onset to imaging time was shorter in the IVT+ group (median 103 vs 140 min). In contrast, imaging to puncture time was longer in the IVT+ group (median 107 vs 91 min). In IPTW analysis, the IVT+ group had higher odds of favorable outcome, excellent outcome (90-day mRS score 0-1), and successful reperfusion (modified Thrombolysis in Cerebral Infarction score 2b/3 at the end of EVT). There was no difference in the risk of significant hemorrhagic complications between groups. In secondary analysis of patients treated with acute cervical internal carotid artery stenting, bridging therapy was associated with higher odds of favorable outcome and lower odds of mortality at 90 days. Conclusions: Our results suggest that bridging therapy in patients with acute ischemic stroke due to anterior tandem occlusion is safe and may improve functional outcome, even in the setting of acute cervical internal carotid artery stenting during EVT. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Background: The best recanalization strategy for mechanical thrombectomy (MT) remains unknown as no randomized controlled trial has simultaneously evaluated first-line stent retriever (SR) versus contact aspiration (CA) versus the combined approach (SR+CA). Objective: To compare the efficacy and safety profiles of SR, CA, and SR+CA in patients with acute ischemic stroke (AIS) treated by MT. Methods: We analyzed data of the Endovascular Treatment in Ischemic Stroke (ETIS) Registry, a prospective, multicenter, observational study of patients with AIS treated by MT. Patients with M1 and intracranial internal carotid artery (ICA) occlusions between January 2015 and March 2020 in 15 comprehensive stroke centers were included. We assessed the association of first-line strategy with favorable outcomes at 3 months (modified Rankin Scale score 0-2), successful recanalization rates (modified Thrombolysis In Cerebral Infarction (mTICI) 2b/3), and safety outcomes. Results: We included 2643 patients, 406 treated with SR, 1126 with CA, and 1111 with SR+CA. CA or SR+CA achieved more successful recanalization than SR for M1 occlusions (aOR=2.09, (95% CI 1.39 to 3.13) and aOR=1.69 (95% CI 1.12 to 2.53), respectively). For intracranial ICA, SR+CA achieved more recanalization than SR (aOR=2.52 (95% CI 1.32 to 4.81)), no differences were observed between CA and SR+CA. SR+CA was associated with lower odds of favorable outcomes compared with SR (aOR=0.63 (95% CI 0.44 to 0.90)) and CA (aOR=0.71 (95% CI 0.55 to 0.92)), higher odds of mortality at 3 months (aOR=1.56 (95% CI 1.22 to 2.0)) compared with CA, and higher odds of symptomatic intracranial hemorrhage (aOR=1.59 (95% CI 1.1 to 2.3)) compared with CA. Conclusions: Despite high recanalization rates, our results question the safety of the combined approach, which was associated with disability and mortality. Randomized controlled trials are needed to evaluate the efficacy and safety of these techniques. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.