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 |
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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 |
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