Hypoperfusion intensity ratio correlates with collaterals and predicts outcome and infarct volume in acute ischemic stroke patients.

Autor: Busto G; Neuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy., Morotti A; Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Casetta I; Section of Neurology, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy., Barra A; Department of Technical Health Professions and Rehabilitation, Careggi University Hospital, Florence, Italy., Fiorenza A; Neuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy., Di Pasquale F; Neuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy., Maccaglia MG; Diagnostic Imaging Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy., Toffali M; Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Mancini S; Neuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy., Carlesi E; Neuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy., Palumbo V; Stroke Unit, Careggi University Hospital, Florence, Italy., Lombardo I; Neuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy., Padovani A; Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Fainardi E; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
Jazyk: angličtina
Zdroj: European journal of clinical investigation [Eur J Clin Invest] 2024 Oct; Vol. 54 (10), pp. e14264. Date of Electronic Publication: 2024 Jun 10.
DOI: 10.1111/eci.14264
Abstrakt: Background: Hypoperfusion Intensity Ratio (HIR) is associated with collaterals and outcome in acute ischemic stroke (AIS). We investigated whether a combined assessment of HIR and collaterals could provide an added value.
Methods: Retrospective single-center study, including AIS patients with large vessel occlusion and endovascular treatment 0-24 h from onset. Predictors of FIV and outcome (90 days modified Rankin Scale 0-1) were investigated with linear and logistic regression respectively. Subjects were stratified in three groups: poor collaterals (grade 0-3) with poor HIR (≥.4), good collaterals (grade 4-5) with poor HIR/poor collaterals with good HIR (<.4) and good collaterals with good HIR.
Results: We included 337 patients (median age 77, 53.1% males), of whom 100 (29.7%) had excellent outcome. One hundred and forty five patients with favourable collateral and HIR profiles had smaller infarct (median poor collaterals with poor HIR 41 mL, good collaterals with poor HIR/poor collaterals with good HIR 21 mL and good collaterals with good HIR 11 mL, p <.001) and higher rates of excellent outcome (poor collaterals with poor HIR 15.7%, good collaterals with poor HIR/poor collaterals with good HIR 26.2% and good collaterals with good HIR 39.3% p =.001). Logistic regression showed that patients with favourable collateral and HIR profiles had the highest odds of good outcome (OR: 3.83, 95% CI 1.62-9.08, p =.002).
Conclusion: Collaterals and HIR are independent predictors of final infarct lesion and outcome in stroke patients and their integration provides an added value. These findings might inform clinical practice and future trials.
(© 2024 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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