Endovascular treatment for calcified cerebral emboli in patients with acute ischemic stroke
| العنوان: | Endovascular treatment for calcified cerebral emboli in patients with acute ischemic stroke |
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| المؤلفون: | Praneeta R Konduri, Heleen M.M. van Beusekom, Henk A. Marquering, Hester F. Lingsma, Aladdin Taha, Diederik W.J. Dippel, Bart J. Emmer, Wim H. van Zwam, Yvo B.W.E.M. Roos, Nikki Boodt, Nerea Arrarte Terreros, Agnetha A E Bruggeman, Adriaan C.G.M. van Es, Manon Kappelhof, Hajo M Hund, Manon L. Tolhuisen, Aad van der Lugt, Clean Registry Investigators, Charles B. L. M. Majoie, Alida A. Postma |
| المساهمون: | Biomedical Engineering and Physics, Graduate School, Radiology and Nuclear Medicine, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Neurovascular Disorders, Amsterdam Neuroscience - Cellular & Molecular Mechanisms, Amsterdam Neuroscience - Compulsivity, Impulsivity & Attention, Neurology, Radiology & Nuclear Medicine, Public Health, Cardiology, Radiology and nuclear medicine, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: DA BV AIOS Radiologie (9) |
| المصدر: | Journal of neurosurgery, 135(5), 1402-1412. American Association of Neurological Surgeons Journal of Neurosurgery, 135(5), 1402-1412. American Association of Neurological Surgeons Bruggeman, A A E, Kappelhof, M, Terreros, N A, Tolhuisen, M L, Konduri, P R, Boodt, N, van Beusekom, H M M, Hund, H M, Taha, A, van der Lugt, A, Roos, Y B W E M, van Es, A C G M, van Zwam, W H, Postma, A A, Dippel, D W J, Lingsma, H F, Marquering, H A, Emmer, B J & Majoie, C B L M 2021, ' Endovascular treatment for calcified cerebral emboli in patients with acute ischemic stroke ', Journal of Neurosurgery, vol. 135, no. 5, pp. 1402-1412 . https://doi.org/10.3171/2020.9.JNS201798 Journal of Neurosurgery, 135(5), 1402-1412. AMER ASSOC NEUROLOGICAL SURGEONS |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | endovascular treatment, medicine.medical_specialty, medicine.medical_treatment, Logistic regression, vascular disorders, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Endovascular treatment, Stroke, TISSUE-PLASMINOGEN ACTIVATOR, business.industry, Cerebral infarction, Mortality rate, General Medicine, Thrombolysis, THROMBECTOMY, RESCUE, medicine.disease, stroke, 030220 oncology & carcinogenesis, interventional neurosurgery, Cardiology, Observational study, business, 030217 neurology & neurosurgery, SIGN, calcified cerebral emboli |
| الوصف: | OBJECTIVE Calcified cerebral emboli (CCE) are a rare cause of acute ischemic stroke. The authors aimed to assess the association of CCE with functional outcome, successful reperfusion, and mortality. Furthermore, they aimed to assess the effectiveness of intravenous alteplase treatment and endovascular treatment (EVT), as well as the best first-line EVT approach in patients with CCE. METHODS The Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry is a prospective, observational multicenter registry of patients treated with EVT for acute ischemic stroke in 16 intervention hospitals in the Netherlands. The association of CCE with functional outcome, reperfusion, and mortality was evaluated using logistic regression models. Univariable comparisons were made to determine the effectiveness of intravenous alteplase treatment and the best first-line EVT approach in CCE patients. RESULTS The study included 3077 patients from the MR CLEAN Registry. Fifty-five patients (1.8%) had CCE. CCE were not significantly associated with worse functional outcome (adjusted common OR 0.71, 95% CI 0.44–1.15), and 29% of CCE patients achieved functional independence. An extended Thrombolysis in Cerebral Infarction score ≥ 2B was significantly less often achieved in CCE patients compared to non-CCE patients (adjusted OR [aOR] 0.52, 95% CI 0.28–0.97). Symptomatic intracranial hemorrhage occurred in 8 CCE patients (15%) vs 171 of 3022 non-CCE patients (6%; p = 0.01). The median improvement on the National Institutes of Health Stroke Scale (NIHSS) was 2 in CCE patients versus 4 in non-CCE patients (p = 0.008). CCE were not significantly associated with mortality (aOR 1.16, 95% CI 0.64–2.12). Intravenous alteplase use in CCE patients was not associated with functional outcome or reperfusion. In CCE patients with successful reperfusion, stent retrievers were more often used as the primary treatment device (p = 0.04). CONCLUSIONS While patients with CCE had significantly lower reperfusion rates and less improvement on the NIHSS after EVT, CCE were not significantly associated with worse functional outcome or higher mortality rates. Therefore, EVT should still be considered in this specific group of patients. |
| اللغة: | English |
| تدمد: | 0022-3085 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2a1d61595929cc5f1545559df0835a2f https://pure.amc.nl/en/publications/endovascular-treatment-for-calcified-cerebral-emboli-in-patients-with-acute-ischemic-stroke(3172babd-db22-4463-96b9-6d004b206515).html |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....2a1d61595929cc5f1545559df0835a2f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00223085 |
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