Tissue no-reflow despite full recanalization following thrombectomy for anterior circulation stroke with proximal occlusion: A clinical study
| العنوان: | Tissue no-reflow despite full recanalization following thrombectomy for anterior circulation stroke with proximal occlusion: A clinical study |
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| المؤلفون: | Sylvain Charron, Adrien Ter Schiphorst, Wagih Ben Hassen, Corentin Provost, Pierre Seners, Guillaume Turc, Jean-Claude Baron, Joseph Benzakoun, Catherine Oppenheim, Olivier Naggara |
| المساهمون: | Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Service de neuroradiologie [Paris], Hôpital Sainte-Anne, Département de Neurologie [Hôpital Sainte-Anne - APHP] (Paris CB2 2QQ), Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Martinez Rico, Clara |
| المصدر: | Journal of Cerebral Blood Flow and Metabolism Journal of Cerebral Blood Flow and Metabolism, Nature Publishing Group, 2020, pp.271678X20954929. ⟨10.1177/0271678X20954929⟩ |
| بيانات النشر: | HAL CCSD, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | medicine.medical_specialty, medicine.medical_treatment, cerebral blood flow, Infarction, Key-words: perfusion, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, large vessel occlusion, medicine, cardiovascular diseases, Stroke, Proximal occlusion, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, cerebral infarction diaschisis, Cerebral infarction, business.industry, Thrombolysis, medicine.disease, cerebral infarction, arterial spin labeling, Perfusion, Neurology, Cerebral blood flow, Cohort, Cardiology, Neurology (clinical), arterial spin labelling, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | International audience; Despite early thrombectomy, a sizeable fraction of acute stroke patients with large vessel occlusion have poor outcome. The no-reflow phenomenon, i.e. impaired microvascular reperfusion despite complete recanalization, may contribute to such "futile recanalizations". Although well reported in animal models, no-reflow is still poorly characterized in man. From a large prospective thrombectomy database, we included all patients with intracranial proximal occlusion, complete recanalization (modified thrombolysis in cerebral infarction score 2c-3), and availability of both baseline and 24 h follow-up MRI including arterial spin labeling perfusion mapping. No-reflow was operationally defined as i) hypoperfusion ≥40% relative to contralateral homologous region, assessed with both visual (two independent investigators) and automatic image analysis, and ii) infarction on follow-up MRI. Thirty-three patients were eligible (median age: 70 years, NIHSS: 18, and stroke onset-to-recanalization delay: 208 min). The operational criteria were met in one patient only, consistently with the visual and automatic analyses. This patient recanalized 160 min after stroke onset and had excellent functional outcome. In our cohort of patients with complete and stable recanalization following thrombectomy for intracranial proximal occlusion, severe ipsilateral hypoperfusion on follow-up imaging associated with newly developed infarction was a rare occurrence. Thus, no-reflow may be infrequent in human stroke and may not substantially contribute to futile recanalizations. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0271-678X 1559-7016 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c5303e0b33902f20a557007b31ba6ff4Test https://www.hal.inserm.fr/inserm-02978221Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c5303e0b33902f20a557007b31ba6ff4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 0271678X 15597016 |
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