Predictors of reperfusion in patients with acute ischemic stroke
| Autor: | Horsch, A.D., Dankbaar, J.W., Niesten, J.M., Seeters, T. van, Schaaf, I.C. van der, Graaf, Y. van der, Mali, W.P., Velthuis, B.K., Meijer, F.J.A., Dijk, E.J. van |
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| Přispěvatelé: | Public Health, ACS - Amsterdam Cardiovascular Sciences, ANS - Amsterdam Neuroscience, Radiology and Nuclear Medicine, Neurology |
| Rok vydání: | 2015 |
| Předmět: |
Male
Multivariate analysis Logistic regression Tissue plasminogen activator EVALUATION TRIAL EPITHET Brain Ischemia law.invention Randomized controlled trial law Non-U.S. Gov't Acute ischemic stroke Research Support Non-U.S. Gov't INFARCT SIZE Brain PERFUSION-CT Middle Aged Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] Stroke Treatment Outcome Reperfusion Injury Cardiology CT-ANGIOGRAPHY Female INTRAVENOUS THROMBOLYSIS Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] medicine.drug medicine.medical_specialty Neovascularization Physiologic CLOT BURDEN SCORE Research Support Internal medicine medicine Journal Article Humans Radiology Nuclear Medicine and imaging In patient Thrombus TISSUE-PLASMINOGEN ACTIVATOR Aged business.industry medicine.disease RANDOMIZED-TRIAL Cerebral Angiography Surgery Logistic Models Relative risk Multivariate Analysis Neurology (clinical) HEMORRHAGIC TRANSFORMATION Tomography X-Ray Computed business ARTERIAL-OCCLUSION |
| Zdroj: | AJNR American Journal of Neuroradiology, 36, 1056-62 American Journal of Neuroradiology, 36(6), 1056. American Society of Neuroradiology AJNR American Journal of Neuroradiology, 36, 6, pp. 1056-62 American Journal of Neuroradiology, 36(6), 1056-1062. American Society of Neuroradiology AJNR. American journal of neuroradiology, 36(6), 1056-1062. American Society of Neuroradiology AJNR Am J Neuroradiol |
| ISSN: | 0195-6108 |
| Popis: | Item does not contain fulltext BACKGROUND AND PURPOSE: Ischemic stroke studies emphasize a difference between reperfusion and recanalization, but predictors of reperfusion have not been elucidated. The aim of this study was to evaluate the relationship between reperfusion and recanalization and identify predictors of reperfusion. MATERIALS AND METHODS: From the Dutch Acute Stroke Study, 178 patients were selected with an MCA territory deficit on admission CTP and day 3 follow-up CTP and CTA. Reperfusion was evaluated on CTP, and recanalization on CTA, follow-up imaging. Reperfusion percentages were calculated in patients with and without recanalization. Patient admission and treatment characteristics and admission CT imaging parameters were collected. Their association with complete reperfusion was analyzed by using univariate and multivariate logistic regression. RESULTS: Sixty percent of patients with complete recanalization showed complete reperfusion (relative risk, 2.60; 95% CI, 1.63-4.13). Approximately one-third of patients showed some discrepancy between recanalization and reperfusion status. Lower NIHSS score (OR, 1.06; 95% CI, 1.01-1.11), smaller infarct core size (OR, 3.11; 95% CI, 1.46-6.66; and OR, 2.40; 95% CI, 1.14-5.02), smaller total ischemic area (OR, 4.20; 95% CI, 1.91-9.22; and OR, 2.35; 95% CI, 1.12-4.91), lower clot burden (OR, 1.35; 95% CI, 1.14-1.58), distal thrombus location (OR, 3.02; 95% CI, 1.76-5.20), and good collateral score (OR, 2.84; 95% CI, 1.34-6.02) significantly increased the odds of complete reperfusion. In multivariate analysis, only total ischemic area (OR, 6.12; 95% CI, 2.69-13.93; and OR, 1.91; 95% CI, 0.91-4.02) was an independent predictor of complete reperfusion. CONCLUSIONS: Recanalization and reperfusion are strongly associated but not always equivalent in ischemic stroke. A smaller total ischemic area is the only independent predictor of complete reperfusion. |
| Databáze: | OpenAIRE |
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