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논문 기본 정보

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학술저널
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민제홍 (아주대학교) Lee Seong-Joon (Department of Radiology Ajou University School of Medicine Suwon Korea) Hong Ji Man (Department of Neurology Ajou University School of Medicine Suwon Korea) 최진욱 (아주대학교) Kang Dong-Hun (School of Medicine Kyungpook National University Daegu Korea) Kim Yong-Won (School of Medicine Kyungpook National University Daegu Korea) 김용선 (경북대학교) 홍정호 (계명대학교) Yoo Joonsang (Keimyung University Dongsan Medical Center Daegu Korea) 김창현 (계명대학교) Sohn Sung-Il (Department of Neurology Keimyung University Dongsan Hostpial Keimyung University School of Medicine) Hwang Yang-Ha (School of Medicine Kyungpook National University Daegu Korea) Lee Jin Soo (Department of Neurology Ajou University School of Medicine Ajou University Medical Center Suwon)
저널정보
대한신경중재치료의학회 Neurointervention Neurointervention Vol.14 No.2
발행연도
2019.1
수록면
107 - 115 (9page)

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Purpose Emergent intracranial occlusions causing acute ischemic stroke are often related to extracranial atherosclerotic stenosis. This study aimed to investigate the association between post-procedure intracerebral hemorrhage (ICH) and emergent extracranial artery stenting and assess their effects on clinical outcomes in patients with acute ischemic stroke. Materials and Methods We retrospectively analyzed patients undergoing hyperacute endovascular treatment for cervicocephalic vascular occlusion in three Korean hospitals between January 2011 and February 2016. Patients who had extracranial artery involvement and were treated from 24 hours of symptom onset to puncture were included in this study, and they were divided into the extracranial stenting (ES) and non-ES groups. Any type of petechial hemorrhages and parenchymal hematoma was defined as ICH for the current study. Results In total, 76 patients were included in this study. Among them, 56 patients underwent ES, and 20 patients did not. Baseline characteristics, risk factors, laboratory data, treatment methods, successful reperfusion rates, and baseline stenotic degrees of extracranial internal carotid artery did not differ between these two groups. However, atrial fibrillation was more frequent in patients without than with ES (P=0.002), and post-procedure ICH was more frequent in patients with than without ES (P=0.035). Logistic regression models revealed that ES was independently associated with post-procedure ICH (odds ratio [OR], 7.807; 95% confidence interval [CI], 1.213–50.248; P=0.031), and ICH was independently associated with poor clinical outcomes (OR, 0.202; 95% CI, 0.054–0.759; P=0.018); however, ES itself was not associated with clinical outcomes (OR, 0.530; 95% CI, 0.117–2.395; P=0.409). Notably, ICH and ES had interaction for predicting good outcomes (P=0.041). Conclusion Post-procedure ICH was associated with ES and poor clinical outcomes. Therefore, ES should be cautiously considered in patients with hyperacute stroke.
#Carotid stenosis #Stents #Cerebral infarction #Endovascular procedures #Cerebral hemorrhage

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참고문헌 (25)

참고문헌 신청
Grau AJ / 2001 / Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank / Stroke 32:2559~2566 google schola Rubiera M / 2006 / Tandem internal carotid artery/middle cerebral artery occlusion: an independent predictor of poor outcome after systemic thrombolysis / Stroke 37:2301~2305 google schola Jovin TG / 2005 / Emergent stenting of extracranial internal carotid artery occlusion in acute stroke has a high revascularization rate / Stroke 36:2426~2430 google schola Papanagiotou P / 2011 / Carotid artery stenting in acute stroke / J Am Coll Cardiol 58:2363~2369 google schola Yoon W / 2015 / Outcomes and prognostic factors after emergent carotid artery stenting for hyperacute stroke within 6 hours of symptom onset / Neurosurgery 76:321~329 google schola

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