Hyperperfusion after Endovascular Reperfusion Therapy for Acute Ischemic Stroke.
J Stroke Cerebrovasc Dis
; 28(5): 1212-1218, 2019 May.
Article
em En
| MEDLINE
| ID: mdl-30704865
ABSTRACT
BACKGROUND AND PURPOSE:
Patients with acute ischemic stroke (AIS) may display prolonged neurological deficits and conscious disturbance even after successful endovascular thrombectomy. We hypothesized that hemodynamic change after reperfusion might influence outcomes. This study investigated the factors causing hyperperfusion and outcomes.METHODS:
We retrospectively analyzed 27 patients with AIS who underwent successful acute revascularization (TICI Thrombolysis in Cerebral Infarction 2bâ¯+â¯3). Changes of the neurological status were precisely assessed by using the National Institutes of Health Stroke Scale (NIHSS). Ischemic lesions were scored by MRI with diffusion-weighted imaging (DWI), and blood flow in the middle cerebral artery territory was assessed by MRI with arterial spin labeling. Univariate analysis was performed to investigate correlations between hyperperfusion and demographic factors or the functional prognosis.RESULTS:
Thirteen of the 27 (48%) patients developed hyperperfusion after reperfusion. A significant correlation was seen between hyperperfusion and the improvement of NIHSS at 24 hours (P < .0001), the duration of disturbance of consciousness (days) (P < .0001), DWI-ASPECTS (P = .001), hemorrhagic transformation (P = .007), and mRS less than or equal to 2 at 90 days (P = .007).CONCLUSIONS:
The present findings suggested that some patients with AIS will develop hyperperfusion after successful acute revascularization. The status of hyperperfusion could prolong conscious disturbance and affect outcomes. Since the mechanism of hyperperfusion after revascularization depends on stroke etiology, diagnosing the type of ischemic stroke in the acute stage is important for managing postoperative treatment.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
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Circulação Cerebrovascular
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Trombectomia
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Transtornos da Consciência
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Artéria Cerebral Média
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Acidente Vascular Cerebral
/
Procedimentos Endovasculares
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Hemodinâmica
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article