지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Background and Purpose The outcomes of acute internal carotid artery (ICA) terminus occlusions are poor. We classified ICA terminus occlusions into 2 groups according to the occlusion pattern of the circle of Willis and hypothesized that clinical outcomes would significantly differ between them.
Methods Consecutive patients with acute ICA terminus occlusions evaluated by baseline computed tomographic angiography were enrolled. We investigated the occlusion patterns in the circle of Willis, retrospectively classified patients into simple ICA terminus occlusion (STO; with good Willisian collaterals from neighboring cerebral circulation) and complex ICA terminus occlusion (CTO; with one or more of A2 anterior cerebral artery, fetal posterior cerebral artery occlusion, or hypoplastic/absent contralateral A1; or with poor collaterals from anterior communicating artery) groups, and compared their baseline characteristics and outcomes.
Results The STO group (n=58) showed smaller infarct volumes at 72 hours than the CTO group (n=34) (median, 81 mL [interquartile range, 38-192] vs. 414 mL [193-540], P<0.001) and more favorable outcomes (3-month modified Rankin Scale 0-3, 44.8% vs. 8.8%, P<0.001; 3-month mortality, 24.1% vs. 67.6%, P<0.001). In multivariable analyses, STO remained an independent predictor for favorable outcomes (odds ratio 6.1, P=0.010).
Conclusions Favorable outcomes in STO group suggested that the outcomes of acute ICA terminus occlusions depend on Willisian collateral status. Documenting the subtypes on computed tomographic angiography would help predict patient outcome.
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참고문헌 (31)
참고문헌 신청
Saqqur M / 2007 / Site of arterial occlusion identified by transcranial Doppler predicts the response to intravenous thrombolysis for stroke / Stroke 38:948~954
Zaidat OO / 2002 / Response to intra-arterial and combined intravenous and intra-arterial thrombolytic therapy in patients with distal internal carotid artery occlusion / Stroke 33:1821~1826
Lee JS / 2013 / The combined use of mechanical thrombectomy devices is feasible for treating acute carotid terminus occlusion / Acta Neurochir(Wien) 155:635~641
Bhatia R / 2010 / Low rates of acute recanalization with intravenous recombinant tissue plasminogen activator in ischemic stroke : real-world experience and a call for action / Stroke 41:2254~2258
Lee JS / 2012 / Comparison of the incidence of parenchymal hematoma and poor outcome in patients with carotid terminus occlusion treated with intra-arterial urokinase alone or with combined IV rtPA and intra-arterial urokinase / AJNR Am J Neuroradiol 33:175~179
Zaidat OO / 2002 / Response to intra-arterial and combined intravenous and intra-arterial thrombolytic therapy in patients with distal internal carotid artery occlusion / Stroke 33:1821~1826
Lee JS / 2013 / The combined use of mechanical thrombectomy devices is feasible for treating acute carotid terminus occlusion / Acta Neurochir(Wien) 155:635~641
Bhatia R / 2010 / Low rates of acute recanalization with intravenous recombinant tissue plasminogen activator in ischemic stroke : real-world experience and a call for action / Stroke 41:2254~2258
Lee JS / 2012 / Comparison of the incidence of parenchymal hematoma and poor outcome in patients with carotid terminus occlusion treated with intra-arterial urokinase alone or with combined IV rtPA and intra-arterial urokinase / AJNR Am J Neuroradiol 33:175~179
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