Perfusion imaging and recurrent cerebrovascular events in intracranial atherosclerotic disease or carotid occlusion
| Autor: | Morgan Hemendinger, Joshua Z. Willey, Daniel Sacchetti, Randolph S. Marshall, Mahesh V Jayaraman, Karen L. Furie, Matthew S Siket, Ryan A McTaggart, Shawna Cutting, Mitchell S.V. Elkind, Tina Burton, Shyam Prabhakaran, Brian Mac Grory, Andrew D Chang, Sara K. Rostanski, Bradford B Thompson, Pooja Khatri, Shadi Yaghi |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Risk medicine.medical_specialty Perfusion Imaging Perfusion scanning Disease 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Recurrence Recurrent stroke Internal medicine medicine Humans Carotid Stenosis Stroke Aged Retrospective Studies Aged 80 and over business.industry Atherosclerotic disease Middle Aged Stroke subtype CAROTID OCCLUSION Intracranial Arteriosclerosis Prognosis medicine.disease Neurology Cardiology Female business Perfusion Carotid Artery Internal 030217 neurology & neurosurgery |
| Zdroj: | International Journal of Stroke. 13:592-599 |
| ISSN: | 1747-4949 1747-4930 |
| DOI: | 10.1177/1747493018764075 |
| Popis: | Background Large vessel disease stroke subtype carries the highest risk of early recurrent stroke. In this study we aim to look at the association between impaired perfusion and early stroke recurrence in patients with intracranial atherosclerotic disease or total cervical carotid occlusion. Methods This is a retrospective study from a comprehensive stroke center where we included consecutive patients 18 years or older with intracranial atherosclerotic disease or total cervical carotid occlusion admitted with a diagnosis of ischemic stroke within 24 h from symptom onset with National Institute Health Stroke Scale max > 6 s mismatch volume (penumbra volume–infarct volume) of 15 ml or more. The outcome was recurrent cerebrovascular events at 90 days defined as worsening or new neurological symptoms in the absence of a nonvascular cause attributable to the decline, or new infarct or infarct extension in the territory of the affected artery. We used Cox proportional hazards models to determine the association between impaired perfusion and recurrent cerebrovascular events. Results Sixty-two patients met our inclusion criteria; mean age 66.4 ± 13.1 years, 64.5% male (40/62) and 50.0% (31/62) with intracranial atherosclerotic disease. When compared to patients with favorable perfusion pattern, patients with unfavorable perfusion pattern were more likely to have recurrent cerebrovascular events (55.6% (10/18) versus 9.1% (4/44), p Conclusion Perfusion mismatch predicts recurrent cerebrovascular events in patients with ischemic stroke due to intracranial atherosclerotic disease or total cervical carotid occlusion. Studies are needed to determine the utility of revascularization strategies in this patient population. |
| Databáze: | OpenAIRE |
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