Your browser doesn't support javascript.
loading
Importance of Delayed Reperfusions in Patients With Incomplete Thrombectomy.
Mujanovic, Adnan; Jungi, Noel; Kurmann, Christoph C; Dobrocky, Tomas; Meinel, Thomas R; Almiri, William; Grunder, Lorenz; Beyeler, Morin; Lang, Matthias F; Jung, Simon; Klail, Tomas; Hoffmann, Angelika; Seiffge, David J; Heldner, Mirjam R; Pilgram-Pastor, Sara; Mordasini, Pasquale; Arnold, Marcel; Piechowiak, Eike I; Gralla, Jan; Fischer, Urs; Kaesmacher, Johannes.
Afiliación
  • Mujanovic A; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Jungi N; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Kurmann CC; Department of Neurology (N.J., T.R.M., M.B., S.J., D.J.S., M.R.H., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Dobrocky T; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Meinel TR; University Institute of Diagnostic, Interventional and Pediatric Radiology (C.C.K., L.G.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Almiri W; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Grunder L; Department of Neurology (N.J., T.R.M., M.B., S.J., D.J.S., M.R.H., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Beyeler M; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Lang MF; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Jung S; University Institute of Diagnostic, Interventional and Pediatric Radiology (C.C.K., L.G.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Klail T; Department of Neurology (N.J., T.R.M., M.B., S.J., D.J.S., M.R.H., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Hoffmann A; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Seiffge DJ; Department of Neurology (N.J., T.R.M., M.B., S.J., D.J.S., M.R.H., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Heldner MR; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Pilgram-Pastor S; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Mordasini P; Department of Neuroradiology, Heidelberg University Hospital, Germany (A.H.).
  • Arnold M; Department of Neurology (N.J., T.R.M., M.B., S.J., D.J.S., M.R.H., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Piechowiak EI; Department of Neurology (N.J., T.R.M., M.B., S.J., D.J.S., M.R.H., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Gralla J; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Fischer U; University Institute of Diagnostic and Interventional Neuroradiology (A.M., N.J., C.C.K., T.D., W.A., L.G., M.F.L., T.K., A.H., S.P.P., P.M., E.I.P., J.G., J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
  • Kaesmacher J; Department of Neurology (N.J., T.R.M., M.B., S.J., D.J.S., M.R.H., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
Stroke ; 53(11): 3350-3358, 2022 11.
Article en En | MEDLINE | ID: mdl-36205143
ABSTRACT

BACKGROUND:

There is paucity of data regarding the effects of delayed reperfusion (DR) on clinical outcomes in patients with incomplete reperfusion following mechanical thrombectomy. We hypothesized that DR has a strong association with clinical outcome in patients with incomplete reperfusion after mechanical thrombectomy (expanded Thrombolysis in Cerebral Infarction, 2a-2c).

METHODS:

Single-institution's stroke registry retrospective analysis of patients admitted from February 2015 to December 2020. DR was defined as the absence of any perfusion delay on ≈24-hour contrast-enhanced follow-up perfusion imaging, whereas persistent perfusion deficit denotes a perfusion delay corresponding to the catheter angiographic deficit directly after the intervention. The association of perfusion outcome (DR versus persistent perfusion deficit) with the occurrence of new infarcts and 90-day functional independence (modified Rankin Scale score 0-2) was evaluated using logistic regression analyses. Comparison of predictive accuracy was evaluated by calculating area under the curve for models with and without perfusion outcome.

RESULTS:

In 566 patients (mean age 74, 49.6% female), new infarcts in the incomplete reperfusion areas were less common in DR versus persistent perfusion deficit patients (small punctiform 17.1% versus 25%, large confluent 7.9% versus 63.2%; P=0.001). After adjustment for confounders, DR was a strong predictor of functional independence (adjusted odds ratio, 2.37 [95% CI 1.34-4.23]). There was a significant improvement in predictive accuracy of functional independence when perfusion outcome was added to expanded Thrombolysis in Cerebral Infarction alone (area under the curve 0.57 versus 0.62, P=0.01).

CONCLUSIONS:

Occurrence of DR is closely associated with tissue outcome and functional independence. DR may be an independent prognostic parameter, suggesting it as a potential outcome surrogate for medical rescue therapies.
Asunto(s)
Palabras clave
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Procedimientos Endovasculares Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Stroke Año: 2022 Tipo del documento: Article País de afiliación: Suiza
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Procedimientos Endovasculares Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Stroke Año: 2022 Tipo del documento: Article País de afiliación: Suiza