Factors influencing infarct growth including collateral status assessed using computed tomography in acute stroke patients with large artery occlusion.

Details

Serval ID
serval:BIB_E35BB4D119A3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Factors influencing infarct growth including collateral status assessed using computed tomography in acute stroke patients with large artery occlusion.
Journal
International journal of stroke
Author(s)
Jiang B., Ball R.L., Michel P., Li Y., Zhu G., Ding V., Su B., Naqvi Z., Eskandari A., Desai M., Wintermark M.
ISSN
1747-4949 (Electronic)
ISSN-L
1747-4930
Publication state
Published
Issued date
08/2019
Peer-reviewed
Oui
Volume
14
Number
6
Pages
603-612
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Abstract
In major ischemic stroke caused by a large artery occlusion, neuronal loss varies considerably across individuals without revascularization. This study aims to identify which patient characteristics are most highly associated with this variability. Demographic and clinical information were retrospectively collected on a registry of 878 patients. Imaging biomarkers including Alberta Stroke Program Early CT score, noncontrast head computed tomography infarct volume, perfusion computed tomography infarct core and penumbra, occlusion site, collateral score, and recanalization status were evaluated on the baseline and early follow-up computed tomography images. Infarct growth rates were calculated by dividing infarct volumes by the time elapsed between the computed tomography scan and the symptom onset. Collateral score was graded into four levels (0, 1, 2, and 3) in comparison with the normal side. Correlation of perfusion computed tomography and noncontrast head computed tomography infarct volumes and infarct growth rates were estimated with the nonparametric Spearman's rank correlation. Conditional inference trees were used to identify the clinical and imaging biomarkers that were most highly associated with the infarct growth rate and modified Rankin Scale at 90 days. Two hundred and thirty-two patients met the inclusion criteria for this study. The median infarct growth rates for perfusion computed tomography and noncontrast head computed tomography were 11.2 and 6.2 ml/log(min) in logarithmic model, and 18.9 and 10.4 ml/h in linear model, respectively. Noncontrast head computed tomography and perfusion computed tomography infarct volumes and infarct growth rates were significantly correlated (rho=0.53; P < 0.001). Collateral status was the strongest predictor for infarct growth rates. For collateral=0, the perfusion computed tomography and noncontrast head computed tomography infarct growth rate were 31.56 and 16.86 ml/log(min), respectively. Patients who had collateral >0 and penumbra volumes>92 ml had the lowest predicted perfusion computed tomography infarct growth rates (6.61 ml/log(min)). Collateral status was closely related to the diversity of infarct growth rates, poor collaterals were associated with a faster infarct growth rates and vice versa.
Keywords
Adult, Aged, Aged, 80 and over, Arterial Occlusive Diseases/complications, Arterial Occlusive Diseases/diagnostic imaging, Arterial Occlusive Diseases/pathology, Biomarkers, Cerebral Angiography, Computed Tomography Angiography/methods, Female, Humans, Infarction/diagnostic imaging, Infarction/pathology, Male, Middle Aged, Retrospective Studies, Stroke/complications, Stroke/diagnostic imaging, Stroke/pathology, Ischemic stroke, collateral, computed tomography, perfusion imaging
Pubmed
Web of science
Create date
25/05/2019 13:12
Last modification date
06/03/2020 6:20
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