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논문 기본 정보

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학술저널
저자정보
Woo Ho Geol (Department of Neurology Ewha Womans University College of Medicine Seoul Korea) Jung Cheolkyu (Department of Radiology Seoul National University Bundang Hospital Korea) Sunwoo Leonard (Department of Radiology Seoul National University Bundang Hospital Korea) Bae Yun Jung (Department of Radiology Seoul National University Bundang Hospital Seoul National University Colleg) 최병세 (분당서울대학교병원) Kim Jae Hyoung (Department of Radiology Seoul National University Bundang Hospital Korea) Kim Beom Joon (Department of Neurology Seoul National University Bundang Hospital Korea) Han Moon-Ku (Department of Neurology Seoul National University Bundang Hospital Korea) Bae Hee-Joon (Department of Neurology Cerebrovascular Center Seoul National University Bundang Hospital Seoul Nat) Jung Seunguk (Department of Neurology Gyeongsang National University Changwon Hospital Changwon Korea) 차상훈 (충북대학교병원)
저널정보
대한신경중재치료의학회 Neurointervention Neurointervention Vol.14 No.2
발행연도
2019.1
수록면
99 - 106 (8page)

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Purpose Although endovascular treatment is currently thought to only be suitable for patients who have pial arterial filling scores >3 as determined by multiphase computed tomography angiography (mpCTA), a cut-off score of 3 was determined by a study, including patients within 12 hours after symptom onset. We aimed to investigate whether a cut-off score of 3 for endovascular treatment within 6 hours of symptom onset is an appropriate predictor of good functional outcome at 3 months. Materials and Methods From April 2015 to January 2016, acute ischemic stroke patients treated with mechanical thrombectomy within 6 hours of symptom onset were enrolled into this study. Pial arterial filling scores were semi-quantitatively assessed using mpCTA, and clinical and radiological parameters were compared between patients with favorable and unfavorable outcomes. Multivariate logistic regression analysis was then performed to investigate the independent association between clinical outcome and pial collateral score, with the predictive power of the latter assessed using C-statistics. Results Of the 38 patients enrolled, 20 (52.6%) had a favorable outcome and 18 had an unfavorable outcome, with the latter group showing a lower mean pial arterial filling score (3.6±0.8 vs. 2.4±1.2, P=0.002). After adjusting for variables with a P-value of <0.1 in univariate analysis (i.e., age and National Institutes of Health Stroke Scale score at admission), pial arterial filling scores higher than a cut-off of 2 were found to be independently associated with favorable clinical outcomes (P=0.012). C-statistic analysis confirmed that our model had the highest prediction power when pial arterial filling scores were dichotomized at >2 vs. ≤2. Conclusion A pial arterial filling cut-off score of 2 as determined by mpCTA appears to be more suitable for predicting clinical outcomes following endovascular treatment within 6 hours of symptom onset than the cut-off of 3 that had been previously suggested.
#Stroke #Computed tomography angiography #Thrombectomy

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참고문헌 (16)

참고문헌 신청
Goyal M / 2016 / Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials / Lancet 387:1723~1731 google schola Keun-Sik Hong / 2016 / Update of the Korean Clinical Practice Guidelines for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke / 대한뇌졸중학회지 18(1):102~113 dbpia Powers WJ / 2015 / American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association / Stroke 46:3020~3035 google schola Liebeskind DS / 2014 / Collateral lessons from recent acute ischemic stroke trials / Neurol Res 36:397~402 google schola Christoforidis GA / 2009 / Predictors of hemorrhage following intra-arterial thrombolysis for acute ischemic stroke: the role of pial collateral formation / AJNR Am J Neuroradiol 30:165~170 google schola

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