Ischemic Lesion Growth in Patients with a Persistent Target Mismatch After Large Vessel Occlusion.
Clin Neuroradiol
; 33(1): 41-48, 2023 Mar.
Article
em En
| MEDLINE
| ID: mdl-35789284
ABSTRACT
BACKGROUND:
Failure to reperfuse a cerebral occlusion resulting in a persistent penumbral pattern has not been fully described.METHODS:
We retrospectively reviewed patients with anterior large vessel occlusion who did not receive reperfusion, and underwent repeated perfusion imaging, with baseline imaging <â¯6â¯h after onset and follow-up scans from 16-168â¯h. A persistent target mismatch (PTM) was defined as core volume of <â¯100â¯mL, mismatch ratio >â¯1.2, and mismatch volume >â¯10â¯mL on follow-up imaging. Patients were divided into PTM or non-PTM groups. Ischemic core and penumbral volumes were compared between baseline and follow-up imaging between the two groups, and collateral flow status assessed using CT perfusion collateral index.RESULTS:
A total of 25 patients (14 PTM and 11 non-PTM) were enrolled in the study. Median core volumes increased slightly in the PTM group, from 22 to 36â¯ml. There was a much greater increase in the non-PTM group, from 57 to 190â¯ml. Penumbral volumes were stable in the PTM group from a median of 79â¯ml at baseline to 88â¯ml at follow-up, whereas penumbra was reduced in the non-PTM group, from 120 to 0â¯ml. Collateral flow status was also better in the PTM group and the median collateral index was 33% compared with 44% in the non-PTM group (pâ¯= 0.043).CONCLUSION:
Multiple patients were identified with limited core growth and large penumbra (persistent target mismatch) >â¯16â¯h after stroke onset, likely due to more favorable collateral flow.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
/
Acidente Vascular Cerebral
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article