Impact of diffusion-weighted imaging lesion volume on the success of endovascular reperfusion therapy.

Détails

ID Serval
serval:BIB_091EBA0BC418
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Impact of diffusion-weighted imaging lesion volume on the success of endovascular reperfusion therapy.
Périodique
Stroke
Auteur(s)
Olivot J.M., Mosimann P.J., Labreuche J., Inoue M., Meseguer E., Desilles J.P., Rouchaud A., Klein I.F., Straka M., Bammer R., Mlynash M., Amarenco P., Albers G.W., Mazighi M.
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Statut éditorial
Publié
Date de publication
2013
Volume
44
Numéro
8
Pages
2205-2211
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
BACKGROUND AND PURPOSE: Diffusion-weighted imaging (DWI) lesion volume is associated with poor outcome after thrombolysis, and it is unclear whether endovascular therapies are beneficial for large DWI lesion. Our aim was to assess the impact of pretreatment DWI lesion volume on outcomes after endovascular therapy, with a special emphasis on patients with complete recanalization.
METHODS: We analyzed data collected between April 2007 and November 2011 in a prospective clinical registry. All acute ischemic stroke patients with complete occlusion of internal carotid artery or middle cerebral artery treated by endovascular therapy were included. DWI lesion volumes were measured by the RAPID software. Favorable outcome was defined by modified Rankin Scale of 0 to 2 at 90 days.
RESULTS: A total of 139 acute ischemic stroke patients were included. Median DWI lesion volume was 14 cc (interquartile range, 5-43) after a median onset time to imaging of 110 minutes (interquartile range, 77-178). Higher volume was associated with less favorable outcome (adjusted odds ratio, 0.55; 95% confidence interval, 0.31-0.96). A complete recanalization was achieved in 65 (47%) patients after a median onset time of 238 minutes (interquartile range, 206-285). After adjustment for volume, complete recanalization was associated with more favorable outcome (adjusted odds ratio, 6.32; 95% confidence interval, 2.90-13.78). After stratification of volume by tertiles, complete recanalization was similarly associated with favorable outcome in the upper 2 tertiles (P<0.005).
CONCLUSIONS: Our results emphasize the importance of initial DWI volume and recanalization on clinical outcome after endovascular treatment. Large DWI lesions may still benefit from recanalization in selected patients.
Mots-clé
Aged, Aged, 80 and over, Arterial Occlusive Diseases/pathology, Carotid Artery, Internal/pathology, Diffusion Magnetic Resonance Imaging/instrumentation, Diffusion Magnetic Resonance Imaging/methods, Female, Fibrinolytic Agents/administration & dosage, Humans, Male, Middle Aged, Middle Cerebral Artery/pathology, Prospective Studies, Registries, Severity of Illness Index, Stroke/drug therapy, Stroke/pathology, Thrombolytic Therapy/methods, Tissue Plasminogen Activator/administration & dosage, Treatment Outcome
Pubmed
Open Access
Oui
Création de la notice
08/10/2013 13:18
Dernière modification de la notice
20/08/2019 12:31
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