Elevated glucose is associated with hemorrhagic transformation after mechanical thrombectomy in acute ischemic stroke patients with severe pretreatment hypoperfusion

Autor: Raúl Tudela, Antonio López-Rueda, Sergio Amaro, Ángel Chamorro, Carlos Laredo, Laura Llull, Victor Obach, Napoleon Macias, Xabier Urra, Arturo Renú, Salvatore Rudilosso
Rok vydání: 2020
Předmět:
Male
Isquèmia cerebral
Neurology
Tomografia
Hemodynamics
030204 cardiovascular system & hematology
Brain Ischemia
0302 clinical medicine
Ischemia
Cerebral Blood Volume
Acute ischemic stroke
Stroke
Tomography
Thrombectomy
Aged
80 and over

Multidisciplinary
Brain
Embòlia i trombosi cerebral
Middle Aged
Cerebral ischemia
Magnetic Resonance Imaging
Perfusion
Cerebrovascular Circulation
Cardiology
Medicine
Female
Intracranial Hemorrhages
medicine.medical_specialty
Perfusion Imaging
Science
Hemorrhage
Carbohydrate metabolism
Blood sugar
Neuroprotection
Article
03 medical and health sciences
Magnetic resonance imaging
Imatges per ressonància magnètica
Internal medicine
medicine
Humans
Aged
Cerebral Hemorrhage
Cerebral embolism and thrombosis
business.industry
medicine.disease
Mechanical thrombectomy
Glucose
Glucèmia
Reperfusion
business
Tomography
X-Ray Computed

030217 neurology & neurosurgery
Zdroj: Dipòsit Digital de la UB
Universidad de Barcelona
Scientific Reports, Vol 10, Iss 1, Pp 1-9 (2020)
Scientific Reports
Popis: Several pretreatment variables such as elevated glucose and hypoperfusion severity are related to brain hemorrhage after endovascular treatment of acute stroke. We evaluated whether elevated glucose and severe hypoperfusion have synergistic effects in the promotion of parenchymal hemorrhage (PH) after mechanical thrombectomy (MT). We included 258 patients MT-treated who had a pretreatment computed tomography perfusion (CTP) and a post-treatment follow-up MRI. Severe hypoperfusion was defined as regions with cerebral blood volume (CBV) values p = 0.036), whereas this association was not significant in patients without VLCBV-regions. CBV values measured at pretreatment CTP in coregistered regions that developed PH or infarct at follow-up were not correlated with pretreatment glucose levels, thus suggesting the existence of alternative deleterious mechanisms other than direct glucose-driven hemodynamic impairments. Overall, these results suggest that both severe hypoperfusion and glucose levels should be considered in the evaluation of adjunctive neuroprotective strategies.
Databáze: OpenAIRE