Your browser doesn't support javascript.
loading
Time From Imaging to Endovascular Reperfusion Predicts Outcome in Acute Stroke.
Tsai, Jenny P; Mlynash, Michael; Christensen, Soren; Kemp, Stephanie; Kim, Sun; Mishra, Nishant K; Federau, Christian; Nogueira, Raul G; Jovin, Tudor G; Devlin, Thomas G; Akhtar, Naveed; Yavagal, Dileep R; Bammer, Roland; Straka, Matus; Zaharchuk, Gregory; Marks, Michael P; Albers, Gregory W; Lansberg, Maarten G.
Afiliación
  • Tsai JP; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Mlynash M; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Christensen S; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Kemp S; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Kim S; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Mishra NK; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Federau C; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Nogueira RG; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Jovin TG; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Devlin TG; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Akhtar N; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Yavagal DR; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Bammer R; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Straka M; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Zaharchuk G; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Marks MP; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Albers GW; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
  • Lansberg MG; From the Department of Neurology (J.P.T., M.M., S.C., S. Kemp, S. Kim, N.M., C.F., M.S., G.W.A., M.G.L.) and Department of Radiology (R.B., G.Z., M.P.M.), Stanford University, CA; Department of Neurology, Emory University, Atlanta, GA (R.G.N.); Department of Neurology, University of Pittsburgh Medic
Stroke ; 49(4): 952-957, 2018 04.
Article en En | MEDLINE | ID: mdl-29581341
ABSTRACT
BACKGROUND AND

PURPOSE:

This study aims to describe the relationship between computed tomographic (CT) perfusion (CTP)-to-reperfusion time and clinical and radiological outcomes, in a cohort of patients who achieve successful reperfusion for acute ischemic stroke.

METHODS:

We included data from the CRISP (Computed Tomographic Perfusion to Predict Response in Ischemic Stroke Project) in which all patients underwent a baseline CTP scan before endovascular therapy. Patients were included if they had a mismatch on their baseline CTP scan and achieved successful endovascular reperfusion. Patients with mismatch were categorized into target mismatch and malignant mismatch profiles, according to the volume of their Tmax >10s lesion volume (target mismatch, <100 mL; malignant mismatch, >100 mL). We investigated the impact of CTP-to-reperfusion times on probability of achieving functional independence (modified Rankin Scale, 0-2) at day 90 and radiographic outcomes at day 5.

RESULTS:

Of 156 included patients, 108 (59%) had the target mismatch profile, and 48 (26%) had the malignant mismatch profile. In patients with the target mismatch profile, CTP-to-reperfusion time showed no association with functional independence (P=0.84), whereas in patients with malignant mismatch profile, CTP-to-reperfusion time was strongly associated with lower probability of functional independence (odds ratio, 0.08; P=0.003). Compared with patients with target mismatch, those with the malignant mismatch profile had significantly more infarct growth (90 [49-166] versus 43 [18-81] mL; P=0.006) and larger final infarct volumes (110 [61-155] versus 48 [21-99] mL; P=0.001).

CONCLUSIONS:

Compared with target mismatch patients, those with the malignant profile experience faster infarct growth and a steeper decline in the odds of functional independence, with longer delays between baseline imaging and reperfusion. However, this does not exclude the possibility of treatment benefit in patients with a malignant profile.
Asunto(s)
Palabras clave
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trombectomía / Recuperación de la Función / Infarto de la Arteria Cerebral Media / Procedimientos Endovasculares / Tiempo de Tratamiento Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Stroke Año: 2018 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trombectomía / Recuperación de la Función / Infarto de la Arteria Cerebral Media / Procedimientos Endovasculares / Tiempo de Tratamiento Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Stroke Año: 2018 Tipo del documento: Article