التفاصيل البيبلوغرافية
| العنوان: |
Association between computed tomography perfusion and the effect of intravenous alteplase prior to endovascular treatment in acute ischemic stroke. |
| المؤلفون: |
Hoving, Jan W., van Voorst, Henk, Peerlings, Daan, Daems, Jasper D., Koopman, Miou S., Wouters, Anke, Kappelhof, Manon, LeCouffe, Natalie E., Treurniet, Kilian M., Bruggeman, Agnetha A. E., Rinkel, Leon A., van den Wijngaard, Ido R., Coutinho, Jonathan M., van der Lugt, Aad, Marquering, Henk A., Roos, Yvo B. W. E. M., Majoie, Charles B. L. M., Emmer, Bart J. |
| المصدر: |
Neuroradiology; Jun2023, Vol. 65 Issue 6, p1053-1061, 9p |
| مصطلحات موضوعية: |
STATISTICS, INTRAVENOUS therapy, CONFIDENCE intervals, ISCHEMIC stroke, MULTIPLE regression analysis, FUNCTIONAL status, RETROSPECTIVE studies, MANN Whitney U Test, TREATMENT effectiveness, SEVERITY of illness index, STROKE patients, THROMBECTOMY, CHI-squared test, RESEARCH funding, COMPUTED tomography, PERFUSION imaging, ENDOVASCULAR surgery, DATA analysis, ODDS ratio, DATA analysis software, STATISTICAL models, PERFUSION, TISSUE plasminogen activator, ACUTE diseases |
| مستخلص: |
Purpose: Intravenous alteplase (IVT) prior to endovascular treatment (EVT) is neither superior nor noninferior to EVT alone in acute ischemic stroke patients. We aim to assess whether the effect of IVT prior to EVT differs according to CT perfusion (CTP)–based imaging parameters. Methods: In this retrospective post hoc analysis, we included patients from the MR CLEAN-NO IV with available CTP data. CTP data were processed using syngo.via (version VB40). We performed multivariable logistic regression to obtain the effect size estimates (adjusted common odds ratio a[c]OR) on 90-day functional outcome (modified Rankin Scale [mRS]) and functional independence (mRS 0-2) for CTP parameters with two-way multiplicative interaction terms between IVT administration and the studied parameters. Results: In 227 patients, median CTP-estimated core volume was 13 (IQR 5–35) mL. The treatment effect of IVT prior to EVT on outcome was not altered by CTP-estimated ischemic core volume, penumbral volume, mismatch ratio, and presence of a target mismatch profile. None of the CTP parameters was significantly associated with functional outcome after adjusting for confounders. Conclusion: In directly admitted patients with limited CTP-estimated ischemic core volumes who presented within 4.5 h after symptom onset, CTP parameters did not statistically significantly alter the treatment effect of IVT prior to EVT. Further studies are needed to confirm these results in patients with larger core volumes and more unfavorable baseline perfusion profiles on CTP imaging. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
