Ischemic core and hypoperfusion volumes predict infarct size in SWIFT PRIME
| العنوان: | Ischemic core and hypoperfusion volumes predict infarct size in SWIFT PRIME |
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| المؤلفون: | Albers, Gregory W., Goyal, Mayank, Jahan, Reza, Bonafe, Alain, Diener, Hans Christoph, Levy, Elad I., Pereira, Vitor M., Cognard, Christophe, Cohen, David J., Hacke, Werner, Jansen, Olav, Jovin, Tudor G., Mattle, Heinrich P., Nogueira, Raul G., Siddiqui, Adnan H., Yavagal, Dileep R., Baxter, Blaise W., Devlin, Thomas G., Lopes, Demetrius K., Reddy, Vivek K., du Mesnil de Rochemont, Richard, Singer, Oliver C., Bammer, Roland, Saver, Jeffrey L. |
| المساهمون: | Hotchkiss Brain Institute, University of California [Los Angeles] (UCLA), University of California, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Universität Duisburg-Essen [Essen], Universidade do Minho, Neuroradiologie Diagnostique et Thérapeutique [Toulouse], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Institut des Systèmes Intelligents et de Robotique (ISIR), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Universität Heidelberg [Heidelberg], University of Pittsburgh (PITT), Pennsylvania Commonwealth System of Higher Education (PCSHE), Emory University [Atlanta, GA], University at Buffalo [SUNY] (SUNY Buffalo), State University of New York (SUNY), Cardiology Division, Massachusetts General Hospital [Boston], Stanford School of Medicine [Stanford], Stanford Medicine, Stanford University-Stanford University, University of California (UC), Institut des Neurosciences de Montpellier (INM), Universität Duisburg-Essen = University of Duisburg-Essen [Essen], Universidade do Minho = University of Minho [Braga], Service Neuroradiologie Diagnostique et Thérapeutique [CHU Toulouse], Pôle imagerie médicale [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Universität Heidelberg [Heidelberg] = Heidelberg University |
| المصدر: | Annals of Neurology Annals of Neurology, Wiley, 2016, 79 (1), pp.76-89. ⟨10.1002/ana.24543⟩ Annals of Neurology, 2016, 79 (1), pp.76-89. ⟨10.1002/ana.24543⟩ |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Aged, 80 and over, Male, Endovascular Procedures, Medizin, Contrast Media, Cerebral Infarction, Middle Aged, Prognosis, Magnetic Resonance Imaging, Brain Ischemia, Stroke, Fibrinolytic Agents, Cerebrovascular Circulation, Tissue Plasminogen Activator, Outcome Assessment, Health Care, Humans, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Female, Prospective Studies, Tomography, X-Ray Computed, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Aged |
| الوصف: | International audience; OBJECTIVE:Within the context of a prospective randomized trial (SWIFT PRIME), we assessed whether early imaging of stroke patients, primarily with computed tomography (CT) perfusion, can estimate the size of the irreversibly injured ischemic core and the volume of critically hypoperfused tissue. We also evaluated the accuracy of ischemic core and hypoperfusion volumes for predicting infarct volume in patients with the target mismatch profile.METHODS:Baseline ischemic core and hypoperfusion volumes were assessed prior to randomized treatment with intravenous (IV) tissue plasminogen activator (tPA) alone versus IV tPA + endovascular therapy (Solitaire stent-retriever) using RAPID automated postprocessing software. Reperfusion was assessed with angiographic Thrombolysis in Cerebral Infarction scores at the end of the procedure (endovascular group) and Tmax > 6-second volumes at 27 hours (both groups). Infarct volume was assessed at 27 hours on noncontrast CT or magnetic resonance imaging (MRI).RESULTS:A total of 151 patients with baseline imaging with CT perfusion (79%) or multimodal MRI (21%) were included. The median baseline ischemic core volume was 6 ml (interquartile range= 0-16). Ischemic core volumes correlated with 27-hour infarct volumes in patients who achieved reperfusion (r = 0.58, p < 0.0001). In patients who did not reperfuse ( 6-second lesion volumes correlated with 27-hour infarct volume (r = 0.78, p = 0.005). In target mismatch patients, the union of baseline core and early follow-up Tmax > 6-second volume (ie, predicted infarct volume) correlated with the 27-hour infarct volume (r = 0.73, p < 0.0001); the median absolute difference between the observed and predicted volume was 13 ml.INTERPRETATION:Ischemic core and hypoperfusion volumes, obtained primarily from CT perfusion scans, predict 27-hour infarct volume in acute stroke patients who were treated with reperfusion therapies. |
| تدمد: | 1531-8249 0364-5134 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::d75e27f5a133012dc0240d47930efc97Test https://pubmed.ncbi.nlm.nih.gov/26476022Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.pmid.dedup....d75e27f5a133012dc0240d47930efc97 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15318249 03645134 |
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