Effect of MR-guided perfusion imaging mismatch profiles within 6 h on endovascular thrombectomy outcomes.

Autor: Li X; Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China., Lu Z; Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China., Li S; Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China., Zhu L; Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China., Jiang T; Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China., Sun H; General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China., Pan Y; General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China. panyuqin01@163.com., Zhou J; Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China. zhjsh333@126.com., Deng Q; Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China. qiw_deng@njmu.edu.cn.; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China. qiw_deng@njmu.edu.cn.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2024 Sep 07. Date of Electronic Publication: 2024 Sep 07.
DOI: 10.1007/s10072-024-07751-x
Abstrakt: Background: The treatment of acute ischemic stroke (AIS) aims to achieve early vascular recanalization and reperfusion of the penumbra. However, the effect of early penumbral imaging within 6 h on clinical outcomes remains unclear. The objective of this study was to determine the effect of magnetic resonance-guided (MR-guided) perfusion imaging within 6 h after symptom onset on endovascular thrombectomy outcomes in AIS patients.
Methods: We prospectively collected the clinical information of consecutive AIS patients undergoing endovascular thrombectomy based on MR-guided perfusion imaging within 6 h after symptom onset from AISRNA and EVTRNA studies. The primary outcome was defined as the poor outcome (mRS > 2 within 90 days). The perfusion-weighted imaging/diffusion-weighted imaging (PWI/DWI) mismatch was assessed by an automated software.
Results: We enrolled 84 patients (25 in the mismatch ≤ 1.8 group and 59 in the mismatch > 1.8 group). Significant difference was found between the mismatch > 1.8 group and the mismatch ≤ 1.8 group for the incidence of disabling stroke (mRS > 2) within 90 days (40.7% vs. 68.0%, OR: 3.099, 95% CI: 1.154-8.323, P = 0.025). Intracranial hemorrhage occurred in 8 patients (13.6%) in the mismatch > 1.8 group and 10 patients in the mismatch ≤ 1.8 group (40.0%) (P = 0.010). The risk of severe cerebral edema was 2/59 (3.4%) vs. 7/25 (28.0%) (P = 0.004). These findings remained stable after adjustment.
Conclusions: MR-guided perfusion imaging mismatch profiles within 6 h after symptom onset may be feasible to predictclinical outcomes and reduce clinically ineffective reperfusion after endovascular thrombectomy.
(© 2024. Fondazione Società Italiana di Neurologia.)
Databáze: MEDLINE
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