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Cerebral Circulation Time After Thrombectomy: A Potential Predictor of Outcome After Recanalization in Acute Stroke

Authors :
Jia‐Qi Wang
Ying‐Jia Wang
Jin Qiu
Wei Li
Xian‐Hui Sun
Yong‐Gang Zhao
Xin Liu
Zi‐Ai Zhao
Liang Liu
Thanh N. Nguyen
Hui‐Sheng Chen
Source :
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 11, Iss 11 (2022)
Publication Year :
2022
Publisher :
Wiley, 2022.

Abstract

Background Despite successful recanalization, up to half of patients with acute ischemic stroke caused by large‐vessel occlusion treated with endovascular treatment (EVT) do not recover to functional independence. We aim to evaluate the role of cerebral circulation time (CCT) as outcome predictor after EVT. Methods and Results We retrospectively enrolled consecutive patients with acute ischemic stroke–large‐vessel occlusion undergoing EVT. Three categories of CCT based on digital subtraction angiography were studied: CCT of the stroke side, CCT of the healthy side), and change of CCT of the stroke side versus CCT of the healthy side. Dramatic clinical recovery was defined as a 24‐hour National Institutes of Health Stroke Scale score ≤2 or ≥8 points drop. A modified Rankin Scale score ≤2 at 3 months was considered a favorable outcome. Logistic regression analysis was performed to evaluate the prediction of CCT on prognosis. One hundred patients were enrolled, of which 38 (38.0%) experienced a dramatic clinical recovery and 43 (43.0%) achieved a favorable outcome. Logistic regression analysis found that shorter change of CCT of the stroke side versus CCT of the healthy side and CCT of the stroke side were independent positive prognostic factors for dramatic clinical recovery (odds ratio [OR], 0.189; P=0.033; OR, 0.581; P=0.035) and favorable outcomes (OR, 0.142; P=0.020; OR, 0.581; P=0.046) after adjustment for potential confounders. A model including the change of CCT of the stroke side versus CCT of the healthy side also had significantly higher area under the curve values compared with the baseline model in patients with dramatic clinical recovery (0.780 versus 0.742) or favorable outcome (0.759 versus 0.713). Conclusions To our knowledge, this is the first report that CCT based on digital subtraction angiography data exhibits an independent predictive performance for clinical outcome in patients with acute ischemic stroke–large‐vessel occlusion after EVT. Given that this readily available CCT can provide alternative perfusion information during EVT, a prospective, multicenter trial is warranted.

Details

Language :
English
ISSN :
20479980
Volume :
11
Issue :
11
Database :
Directory of Open Access Journals
Journal :
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Publication Type :
Academic Journal
Accession number :
edsdoj.032af067c6a542cca58dd20d135a99c7
Document Type :
article
Full Text :
https://doi.org/10.1161/JAHA.122.025853