Presence of the hyperintense acute reperfusion marker on MRI after mechanical thrombectomy for large vessel occlusion is associated with worse early neurological recovery.
J Neurointerv Surg
; 9(7): 641-643, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-27358282
ABSTRACT
BACKGROUND:
Mechanical thrombectomy has become the accepted treatment for large vessel occlusion in acute ischemic stroke. Unfortunately, a large cohort of patients do not achieve functional independence with treatment, even though the results are more robust than with medical management. The hyperintense acute reperfusion marker (HARM) on MRI is an indication of the breakdown of the blood-brain barrier and reperfusion injury.OBJECTIVE:
To examine the hypothesis that the presence of HARM on MRI correlates with worse neurological recovery after reperfusion therapy.METHODS:
We retrospectively reviewed 35 consecutive patients who between February 24, 2016 and April 23, 2016 underwent MRI to determine the presence of HARM after thrombectomy for anterior circulation large vessel occlusion. Demographic, radiographic imaging, and outcome data were collected. Univariate and binary logistic regression models were performed to assess predictors for improvement of the National Institutes of Health Stroke Scale (NIHSS) score by ≥8 points at 24â hours.RESULTS:
The 35 patients studied had an average age of 64±14â years of age with a median NIHSS score of 15 (IQR 9-20). Eighteen patients (51%) were found to have a HARM-positive MRI. In univariate analysis, patients with HARM were older, had lower reperfusion rates and more postprocedural hemorrhages. In binary logistic regression modeling, the absence of HARM was independently associated with a ≥8-point NIHSS score improvement at 24â hours (OR=7.14, 95% CI 1.22 to 41.67).CONCLUSIONS:
This preliminary analysis shows that the presence of HARM may be linked to worse neurological recovery 24â hours after thrombectomy. Reperfusion injury may affect the number of patients achieving functional independence after treatment.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
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Revascularização Cerebral
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Trombectomia
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Recuperação de Função Fisiológica
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Acidente Vascular Cerebral
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article