-
1
المؤلفون: Frank R Hellinger, Maarten G Lansberg, Rishi Gupta, Roy Riascos, Sujan T Reddy, Amrou Sarraj, Ashish Arora, Nirav Vora, Deep Pujara, Peng R Chen, Clark Sitton, Ameer E Hassan, Gary Cutter, Kaushik Parsha, Sheryl Martin-Schild, James C. Grotta, Andrew D Barreto, Spiros Blackburn, Chunyan Cai, Haris Kamal, Bita Imam, Michael G. Abraham, Gregory W. Albers, Diogo C Haussen, Sean I Savitz, Randall C. Edgell
المصدر: Annals of Neurology. 88:1056-1057
مصطلحات موضوعية: medicine.medical_specialty, Neurology, business.industry, Emergency medicine, MEDLINE, Medicine, Neurology (clinical), Endovascular treatment, business, Acute ischemic stroke, Selection (genetic algorithm), Cohort study
-
2
المؤلفون: Sun Kim, Gregory W. Albers, Christian Federau, Roland Bammer, Michael P. Marks, Stephanie Kemp, Soren Christensen, Jenny P Tsai, Matus Straka, Naveed Akhtar, Tudor G Jovin, Maarten G Lansberg, Michael Mlynash, Dileep R. Yavagal, Seena Dehkharghani, Greg Zaharchuk, Diogo C Haussen, Nishant K. Mishra, Thomas Devlin, Raul G. Nogueria
المصدر: Annals of Neurology. 81:849-856
مصطلحات موضوعية: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Penumbra, Perfusion scanning, Magnetic resonance imaging, Odds ratio, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Neurology, Angiography, medicine, Neurology (clinical), Radiology, business, Perfusion, Stroke, 030217 neurology & neurosurgery, Cerebral angiography
الوصف: Objective To assess the utility of computed tomographic (CT) perfusion for selection of patients for endovascular therapy up to 18 hours after symptom onset. Methods We conducted a multicenter cohort study of consecutive acute stroke patients scheduled to undergo endovascular therapy within 90 minutes after a baseline CT perfusion. Patients were classified as “target mismatch” if they had a small ischemic core and a large penumbra on their baseline CT perfusion. Reperfusion was defined as >50% reduction in critical hypoperfusion between the baseline CT perfusion and the 36-hour follow-up magnetic resonance imaging. Results Of the 201 patients enrolled, 190 patients with an adequate baseline CT perfusion study who underwent angiography were included (mean age = 66 years, median NIH Stroke Scale [NIHSS] = 16, median time from symptom onset to endovascular therapy = 5.2 hours). Rate of reperfusion was 89%. In patients with target mismatch (n = 131), reperfusion was associated with higher odds of favorable clinical response, defined as an improvement of ≥8 points on the NIHSS (83% vs 44%; p = 0.002, adjusted odds ratio [OR] = 6.6, 95% confidence interval [CI] = 2.1–20.9). This association did not differ between patients treated within 6 hours (OR = 6.4, 95% CI = 1.5–27.8) and those treated > 6 hours after symptom onset (OR = 13.7, 95% CI = 1.4–140). Interpretation The robust association between endovascular reperfusion and good outcome among patients with the CT perfusion target mismatch profile treated up to 18 hours after symptom onset supports a randomized trial of endovascular therapy in this patient population. Ann Neurol 2017;81:849–856
إعادة تعيين المنقحات
عرض المنقحات (%%عد%%)