Prolonged venous transit is associated with lower odds of excellent recovery after reperfusion in anterior large-vessel occlusion stroke.

Autor:	Salim HA; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA.; Department of Neuroradiology, MD Anderson Medical Center, Houston, Texas, USA., Lakhani DA; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA.; Department of Radiology, West Virginia University, Morgantown, West Virginia, USA., Mei J; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Luna L; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Shahriari M; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Hyson NZ; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Deng F; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Dmytriw AA; Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA.; Neurovascular Centre, Department of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada., Guenego A; Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium., Urrutia VC; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Marsh EB; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Lu H; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Xu R; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Leigh R; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Wolman D; Department of Radiology, Brown University, Providence, Rhode Island, USA., Shah G; Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA., Pulli B; Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, California, USA., Albers GW; Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, California, USA., Hillis AE; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Llinas R; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Nael K; Department of Radiology & Biomedical Imaging, University of California, San Francisco, California, USA., Wintermark M; Department of Neuroradiology, MD Anderson Medical Center, Houston, Texas, USA., Heit JJ; Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, California, USA., Faizy TD; Department of Radiology, Neuroendovascular Program, University Medical Center, Münster, Germany., Yedavalli V; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA.
Jazyk:	angličtina
Zdroj:	European journal of neurology [Eur J Neurol] 2025 Jan; Vol. 32 (1), pp. e16563.
DOI:	10.1111/ene.16563
Abstrakt:	Background and Purpose: Acute ischemic stroke due to anterior circulation large-vessel occlusion (AIS-LVO) remains a leading cause of disability despite successful reperfusion therapies. Prolonged venous transit (PVT) has emerged as a potential prognostic imaging biomarker in AIS-LVO. We aimed to investigate whether PVT is associated with a decreased likelihood of excellent functional outcome (modified Rankin Scale [mRS] score of 0-1 at 90 days) after successful reperfusion. Methods: In our prospectively collected, retrospectively reviewed database, we analyzed data from 104 patients with AIS-LVO who achieved successful reperfusion (modified Thrombolysis in Cerebral Infarction score of 2b/2c/3) between September 2017 and September 2022. PVT was defined as a time to maximum (Tmax) of ≥10 s in the superior sagittal sinus and/or torcula on computed tomography perfusion (CTP) imaging. Patients were categorized into PVT-positive (PVT+) and PVT-negative (PVT-) groups. The primary outcome was excellent functional recovery at 90 days. Results: Of the 104 patients, 30 (29%) were PVT+. Excellent functional outcome was achieved in 38 patients (37%). PVT+ patients had a significantly lower rate of excellent recovery compared to PVT- patients (11% vs. 39%; p < 0.001). After adjusting for possible confounders, PVT positivity was independently associated with lower odds of excellent recovery (adjusted odds ratio 0.11, 95% confidence interval 0.02 to 0.48; p = 0.006). Conclusions: Among patients with AIS-LVO who achieved successful reperfusion, PVT positivity was independently associated with a decreased likelihood of excellent functional outcome at 90 days. Assessment of PVT on CTP may provide valuable prognostic information and aid in clinical decision making for patients with AIS-LVO. (© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze:	MEDLINE
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