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Title: Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

Abstract

BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct coremore » is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.« less

Authors:
; ;  [1];  [2];  [1]
  1. Tampere University Hospital, Medical Imaging Center (Finland)
  2. Tampere University Hospital, Department of Neurology (Finland)
Publication Date:
OSTI Identifier:
22645247
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 4; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; BLOOD; CAROTID ARTERIES; CEREBRAL ARTERIES; COMPARATIVE EVALUATIONS; COMPUTERIZED TOMOGRAPHY; PATIENTS; REGRESSION ANALYSIS; SIMULATION

Citation Formats

Protto, Sara, E-mail: sara.protto@pshp.fi, Pienimäki, Juha-Pekka, Seppänen, Janne, Numminen, Heikki, and Sillanpää, Niko. Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy. United States: N. p., 2017. Web. doi:10.1007/S00270-016-1532-X.
Protto, Sara, E-mail: sara.protto@pshp.fi, Pienimäki, Juha-Pekka, Seppänen, Janne, Numminen, Heikki, & Sillanpää, Niko. Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy. United States. doi:10.1007/S00270-016-1532-X.
Protto, Sara, E-mail: sara.protto@pshp.fi, Pienimäki, Juha-Pekka, Seppänen, Janne, Numminen, Heikki, and Sillanpää, Niko. Sat . "Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy". United States. doi:10.1007/S00270-016-1532-X.
@article{osti_22645247,
title = {Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy},
author = {Protto, Sara, E-mail: sara.protto@pshp.fi and Pienimäki, Juha-Pekka and Seppänen, Janne and Numminen, Heikki and Sillanpää, Niko},
abstractNote = {BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.},
doi = {10.1007/S00270-016-1532-X},
journal = {Cardiovascular and Interventional Radiology},
number = 4,
volume = 40,
place = {United States},
year = {Sat Apr 15 00:00:00 EDT 2017},
month = {Sat Apr 15 00:00:00 EDT 2017}
}