Post-ischemic hyperemia following endovascular therapy for acute stroke is associated with lesion growth.

Autor: Luby M; NIH/NINDS, Stroke Branch, Bethesda, MD, USA., Hsia AW; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; MedStar Washington Hospital Center Comprehensive Stroke Center, Washington, DC, USA., Lomahan CA; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; Suburban Hospital, Johns Hopkins Medicine, Bethesda, MD, USA., Davis R; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; Suburban Hospital, Johns Hopkins Medicine, Bethesda, MD, USA., Burton S; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; MedStar Washington Hospital Center Comprehensive Stroke Center, Washington, DC, USA., Kim Y; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; MedStar Washington Hospital Center Comprehensive Stroke Center, Washington, DC, USA., Craft V; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; MedStar Washington Hospital Center Comprehensive Stroke Center, Washington, DC, USA., Uche V; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; MedStar Washington Hospital Center Comprehensive Stroke Center, Washington, DC, USA., Cabatbat R; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; MedStar Washington Hospital Center Comprehensive Stroke Center, Washington, DC, USA., Adil MM; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; Suburban Hospital, Johns Hopkins Medicine, Bethesda, MD, USA.; Johns Hopkins University School of Medicine, Baltimore, MD, USA., Thomas LC; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; Suburban Hospital, Johns Hopkins Medicine, Bethesda, MD, USA., De Vis JB; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, USA., Afzal MM; NIH/NINDS, Stroke Branch, Bethesda, MD, USA., McGavern D; NIH/NINDS Viral Immunology and Intravital Imaging Section, Bethesda, MD, USA., Lynch JK; NIH/NINDS, Stroke Branch, Bethesda, MD, USA., Leigh R; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.; Johns Hopkins University School of Medicine, Baltimore, MD, USA., Latour LL; NIH/NINDS, Stroke Branch, Bethesda, MD, USA.
Jazyk: angličtina
Zdroj: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism [J Cereb Blood Flow Metab] 2023 Jun; Vol. 43 (6), pp. 856-868. Date of Electronic Publication: 2023 Feb 07.
DOI: 10.1177/0271678X231155222
Abstrakt: A substantial proportion of acute stroke patients fail to recover following successful endovascular therapy (EVT) and injury to the brain and vasculature secondary to reperfusion may be a contributor. Acute stroke patients were included with: i) large vessel occlusion of the anterior circulation, ii) successful recanalization, and iii) evaluable MRI early after EVT. Presence of hyperemia on MRI perfusion was assessed by consensus using a modified ASPECTS. Three different approaches were used to quantify relative cerebral blood flow (rCBF). Sixty-seven patients with median age of 66 [59-76], 57% female, met inclusion criteria. Hyperemia was present in 35/67 (52%) patients early post-EVT, in 32/65 (49%) patients at 24 hours, and in 19/48 (40%) patients at 5 days. There were no differences in incomplete reperfusion, HT, PH-2, HARM, severe HARM or symptomatic ICH rates between those with and without early post-EVT hyperemia. A strong association (R 2  = 0.81, p < 0.001) was found between early post-EVT hyperemia (p = 0.027) and DWI volume at 24 hours after adjusting for DWI volume at 2 hours (p < 0.001) and incomplete reperfusion at 24 hours (p = 0.001). Early hyperemia is a potential marker for cerebrovascular injury and may help select patients for adjunctive therapy to prevent edema, reperfusion injury, and lesion growth.
Databáze: MEDLINE
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