Internal cerebral vein asymmetry is an independent predictor of poor functional outcome in endovascular thrombectomy
| Autor: | May Zin Myint, Leonard LL Yeo, Benjamin Y Q Tan, Ei Zune The, Mei Chin Lim, Ching-Hui Sia, Hock-Luen Teoh, Vijay Kumar Sharma, Bernard Chan, Aftab Ahmad, Prakash Paliwal, Anil Gopinathan, Cunli Yang, Andrew Makmur, Tommy Andersson, Fabian Arnberg, Staffan Holmin |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis medicine.medical_treatment Brain Ischemia Internal medicine Occlusion medicine Humans Stroke Aged Retrospective Studies Thrombectomy business.industry Cerebral infarction Endovascular Procedures Stent General Medicine Thrombolysis Middle Aged medicine.disease Internal Cerebral Vein Collateral circulation Cerebral Veins Treatment Outcome Cardiology Surgery Female Neurology (clinical) business |
| Zdroj: | Journal of neurointerventional surgery. 14(7) |
| ISSN: | 1759-8486 |
| Popis: | BackgroundEndovascular thrombectomy (EVT) in large vessel occlusion (LVO) in anterior circulation acute ischaemic stroke (AIS) results in good functional outcomes in only approximately 60% of the patients. Internal cerebral veins (ICVs) are easily visible, with a consistent midline location, and are linked to stroke outcomes. We hypothesize that ICV asymmetry on multiphasic CT angiogram (mCTA) can be an adjunctive predictor for poor functional outcomes.MethodsWe studied consecutive AIS patients from 2017 to 2019 with anterior circulation LVO treated with EVT regardless of intravenous thrombolysis. Asymmetrical ICV was defined as the presence of hypodensity (less opacification) on the ipsilateral occlusion side as compared with the contralateral side. The primary outcome was modified Rankin Score (mRS) score at 3 months. Secondary outcomes were good recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) 2b-3), symptomatic hemorrhage, and mortality.ResultsA total of 185 patients were included with a median age of 70 years (IQR 59–77); 87 patients (47%) were female. 82 patients (44.3%) achieved good functional outcomes (mRS 0–2) at 3 months. On multivariate analysis, National Institutes of Health Stroke Scale (NIHSS) (OR 1.076, 95% CI 1.015 to 1.140; pConclusionICV asymmetry is a novel radiological sign which is independently associated with poor functional outcomes in EVT, even after correction for collateral circulation. Further studies are needed to validate this finding. |
| Databáze: | OpenAIRE |
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