Relationship between the degree of recanalization and functional outcome in acute ischemic stroke is mediated by penumbra salvage volume

Background The presence of metabolically viable brain tissue that may be salvageable with rapid cerebral blood flow restoration is the fundament rationale for reperfusion therapy in patients with large vessel occlusion stroke. The effect of endovascular treatment (EVT) on functional outcome largely...

Full description

Saved in:
Bibliographic Details
Published in:Journal of neurology 2021-06, Vol.268 (6), p.2213-2222
Main Authors: Broocks, Gabriel, Jafarov, Hashim, McDonough, Rosalie, Austein, Friederike, Meyer, Lukas, Bechstein, Matthias, van Horn, Noel, Nawka, Marie Teresa, Schön, Gerhard, Fiehler, Jens, Kniep, Helge, Hanning, Uta
Format: Article
Language:English
Subjects:
Blood flow
Cardiovascular system
Cerebral blood flow
Cerebral infarction
Computed tomography
Ischemia
Medicine
Medicine & Public Health
Neuroimaging
Neurology
Neuroradiology
Neurosciences
Original Communication
Perfusion
Reperfusion
Stroke
Thrombolysis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background The presence of metabolically viable brain tissue that may be salvageable with rapid cerebral blood flow restoration is the fundament rationale for reperfusion therapy in patients with large vessel occlusion stroke. The effect of endovascular treatment (EVT) on functional outcome largely depends on the degree of recanalization. However, the relationship of recanalization degree and penumbra salvage has not yet been investigated. We hypothesized that penumbra salvage volume mediates the effect of thrombectomy on functional outcome. Methods 99 acute anterior circulation stroke patients who received multimodal CT and underwent thrombectomy with resulting partial to complete reperfusion (modified thrombolysis in cerebral infarction scale (mTICI) ≥ 2a) were retrospectively analyzed. Penumbra volume was quantified on CT perfusion and penumbra salvage volume (PSV) was calculated as difference of penumbra and net infarct growth from admission to follow-up imaging. Results In patients with complete reperfusion (mTICI ≥ 2c), the median PSV was significantly higher than the median PSV in patients with partial or incomplete (mTICI 2a–2b) reperfusion (median 224 mL, IQR: 168–303 versus 158 mL, IQR: 129–225; p  
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-021-10410-2