Association of Venous Outflow Profiles and Successful Vessel Reperfusion After Thrombectomy

Author:

Faizy Tobias Djamsched,Kabiri Reza,Christensen Soren,Mlynash Michael,Kuraitis Gabriella,Mader Marius Marc-Daniel,Albers Gregory W.,Lansberg Maarten G.ORCID,Fiehler JensORCID,Wintermark Max,Marks Michael P.,Heit Jeremy J.

Abstract

ObjectiveRobust arterial collaterals are associated with successful reperfusion after thrombectomy treatment of acute ischemic stroke due to large vessel occlusion (AIS-LVO). Excellent venous outflow (VO) reflects excellent tissue perfusion and collateral status in patients with AIS-LVO. The goal of this study was to determine whether favorable VO profiles assessed on pretreatment CT angiography (CTA) images correlate with successful vessel reperfusion after thrombectomy in patients with AIS-LVO.MethodsThis was a multicenter retrospective cohort study of consecutive patients with AIS-LVO treated by thrombectomy. Baseline CTA was used to assess collateral status (Tan scale) and VO using the Cortical Vein Opacification Score (COVES). Favorable VO was defined as COVES ≥3. Primary outcome was excellent vessel reperfusion status (modified Thrombolysis in Cerebral Infarction 2c/3). Secondary outcome was good functional outcome defined as a score of 0 to 2 on the modified Rankin Scale after 90 days.ResultsFive hundred sixty-five patients met the inclusion criteria. Multivariable logistic regression analysis showed that favorable VO (odds ratio [OR] 2.10 [95% confidence interval (CI) 1.39–3.16]; p < 0.001) was associated with excellent vessel reperfusion during thrombectomy, regardless of good CTA collateral status (OR 0.87 [95% CI 0.58–1.34]; p = 0.48). A favorable VO profile (OR 8.9 [95%CI 5.3–14.9]; p < 0.001) and excellent vessel reperfusion status (OR 2.7 [95%CI 1.7–4.4]; p < 0.001) were independently associated with good functional outcome adjusted for age, sex, glucose, tissue plasminogen activator administration, good CTA collateral status, and presentation NIH Stroke Scale score.ConclusionA favorable VO profile is associated with reperfusion success and good functional outcomes in patients with AIS-LVO treated by endovascular thrombectomy.Classification of EvidenceThis study provides Class II evidence that a favorable VO profile is associated with reperfusion success and good functional outcomes in patients with AIS-LVO treated by endovascular thrombectomy.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical)

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3