Early post-endovascular treatment contrast extravasation on dual-energy CT is associated with clinical and radiological stroke outcomes: A 10-year single-centre experience.
Eur Stroke J
; 8(2): 508-516, 2023 06.
Article
en En
| MEDLINE
| ID: mdl-37231689
ABSTRACT
OBJECTIVE:
To determine the association between early post-endovascular treatment (EVT) contrast extravasation (CE) on dual-energy CT (DECT) and stroke outcomes.METHODS:
EVT records in 2010-2019 were screened. Exclusion criteria included the occurrence of immediate post-procedural intracranial haemorrhage (ICH). Hyperdense areas on iodine overlay maps were scored according to the Alberta Stroke Programme Early CT Score (ASPECTS), thus forming a CE-ASPECTS. Maximum parenchymal iodine concentration and maximum iodine concentration relative to the torcula were recorded. Follow-up imaging was reviewed for ICH. The primary outcome measure was the modified Rankin Scale (mRS) at 90 days.RESULTS:
Out of 651 records, 402 patients were included. CE was found in 318 patients (79%). Thirty-five patients developed ICH on follow-up imaging. Fourteen ICHs were symptomatic. Stroke progression occurred in 59 patients. Multivariable regression showed a significant association between decreasing CE-ASPECTS and the mRS at 90 days (adjusted (a)cOR 1.10, 95% CI 1.03-1.18), NIHSS at 24-48 h (aß 0.57, 95% CI 0.29-0.84), stroke progression (aOR 1.14, 95% CI 1.03-1.26) and ICH (aOR 1.21, 95% CI 1.06-1.39), but not symptomatic ICH (aOR 1.19, 95% CI 0.95-1.38). Iodine concentration was significantly associated with the mRS (acOR 1.18, 95% CI 1.06-1.32), NIHSS (aß 0.68, 95% CI 0.30-1.06), ICH (aOR 1.37, 95% CI 1.04-1.81) and symptomatic ICH (aOR 1.19, 95% CI 1.02-1.38), but not stroke progression (aOR 0.99, 95% CI 0.86-1.15). Results of the analyses with relative iodine concentration were similar and did not improve prediction.CONCLUSIONS:
CE-ASPECTS and iodine concentration are both associated with short- and long-term stroke outcomes. CE-ASPECTS is likely a better predictor for stroke progression.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Accidente Cerebrovascular
/
Yodo
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Eur Stroke J
Año:
2023
Tipo del documento:
Article
País de afiliación:
Países Bajos