Tenacity of Collateral Perfusion in Proximal Cerebral Arterial Occlusions 6–12 h after Onset

Kim, Beom Joon; Kim, Hyeran; Jeong, Han-Gil; Yang, Mi Hwa; Jung, Cheol Kyu; Han, Moon-Ku; Kim, Jae Hyoung ; Demchuk, Andrew M.; Bae, Hee-Joon
August 2018
Cerebrovascular Diseases;Aug2018, Vol. 45 Issue 5/6, p263
Academic Journal
Background: Clinical trials have shown that benefits of endovascular recanalization (EVT) for acute ischemic stroke patients with sizable penumbral tissues seems plausible even beyond 6 h after their last seen normal (LSN). Persistency of ischemic penumbra remains unclear in delayed periods. Methods: From a prospective stroke registry database, we identified 111 acute ischemic stroke patients who had internal carotid artery or middle cerebral artery occlusion with baseline National Institutes of Health Stroke Scale scores ≥6 points and arrived 6–12 h after LSN. Baseline information and functional outcomes were prospectively collected as a clinical registry. Attending physicians made treatment decisions for EVT based on the current guidelines and institutional protocols. MR image parameters, including the volume of diffusion-restricted lesions and mapping of the ­hypoperfused area, were quantified using automated commercial software. Binary logistic regression analysis models, with modified Rankin Scale (mRS) scores of 0–1 at 3 months after stroke included as a dependent variable, were constructed. Results: Between 6 and 12 h after onset, 58% had a mismatch ratio of ≥1.8 at baseline and 42% had favorable imaging profiles as determined by DEFUSE 2 study. After 9 h, there was a mismatch ratio of ≥1.8 in 47 and 38% favorable profiles. EVT was performed in 54% of cases. A 3-month mRS score of 0–1 was found in 19% (25% in EVT and 12% in medical treatment groups) of cases. EVT was associated with an increased OR of having a mRS score of 0–1 at 3 months after stroke (adjusted OR 7.59 [95% CI 1.28–61.60]). Conclusions: Penumbral tissues were persistent in a substantial proportion of anterior circulation occlusion cases 6–12 h after LSN. EVT at 6–12 h in a predominantly Asian cohort resulted in better outcomes.


Related Articles


    An abstract of the article "Totally Percutaneous Endovascular Aortic Repair" by Luo Jiangfang and colleagues is presented.

  • THE RESULTS OF HYPERVASCULARIZED BRAIN TUMORS TREATMENT USING ENDOVASCULAR VESSEL EMBOLIZATION. Ryskeldiyev, N. A.; Teltaev, D. K.; Mustafin, Kh. A.; Ashirov, N. A.; Berdibayeva, D. T.; Moldabekov, A. E.; Talasbayev, M. G.; Surdin, D. A.; Serikkanov, E. S. // Neurosurgery & Neurology of Kazakhstan;2018, Vol. 51 Issue 2, p70 

    Objective: analysis of treatment of patients with brain tumors with the use of vessel embolization. Materials and Methods: The study included 80 patients. There were 35 patients in-group number 1, the embolization of feeding vessels was first performed, removal was carried out. Group number 2...

  • Carotid Artery Stenting:The Need for Randomised Trials. M.M. Brown; W. Hacke // Cerebrovascular Diseases;2004, Vol. 18 Issue 1, p57 

    Endovascular treatment for carotid artery stenosis avoids some of the complications of carotid endarterectomy, but has not been widely accepted. Concerns about the risks and benefits of endovascular treatment led to the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS). There...

  • Endovascular Treatment of Ruptured Vertebral Artery Dissection in the Acute Stage. Inamasu, Joji; Nakamura, Yoshiki; Saito, Ryoichi; Kuroshima, Yoshiaki; Mayanagi, Keita; Ichikizaki, Kiyoshi; Onozuka, Satoshi; Suga, Sadao; Kawase, Takeshi // Cerebrovascular Diseases;2003, Vol. 16 Issue 3, p306 

    Reports on endovascular treatment of ruptured vertebral artery (VA) dissection in the acute stage. Outcomes of the Glasgow Outcome Scale; Clinical and angiographic characteristics of 16 patients with ruptured VA dissection treated endovascularly; Conclusions.

  • Endovascular Therapy: More Questions to be Answered for Best Personalized Interventional Treatment. Hennerici, Michael G. // Cerebrovascular Diseases;Oct2017, Vol. 44 Issue 3/4, pI 

    No abstract available.

  • Interdisciplinary Treatment of Intracranial Infectious Aneurysms. Hamisch, Christina a.; Mpotsaris, anastasios; Timmer, Marco; Reiner, Michael; Stavrinou, Pantelis; Brinker, Gerrit; Goldbrunner, Roland; Krischek, Boris // Cerebrovascular Diseases;Nov2016, Vol. 42 Issue 5/6, p493 

    Objective: Intracranial infectious aneurysms (IIAs) are a rare clinical entity without a definitive treatment guideline. In this study, we evaluate the treatment options of these lesions based on our own clinical experience and review the current knowledge of therapy as portrayed in the...

  • Three Unusual Arteriovenous Fistulas Presenting in Young Children Successfully Treated with Transarterial Endovascular Embolization. Gupta, Rishi; Yi, Hyeong Joong; Jovin, Tudor G.; Horowitz, Michael B. // Pediatric Neurosurgery;Nov/Dec2005, Vol. 41 Issue 6, p328 

    Endovascular approaches can be utilized to manage arteriovenous fistulas (AVFs) either as a stand alone therapy or in conjunction with surgical excision. The goal of treatment is to completely obliterate the AVF. These vascular malformations are rare in childhood and pose a treatment challenge....

  • Endovascular Treatment of Aortic Aneurysms: Techniques and Clinical Update. Chaer, Rabih A.; Makaroun, Michel S.; Chedrawy, Edgar G.; Abdelhady, Khaled; Lele, Himalaya; Massad, Malek G. // Cardiology;2008, Vol. 109 Issue 3, p145 

    Open repair of abdominal and thoracic aortic aneurysms continues to be associated with considerable morbidity and mortality. Endovascular repair of abdominal and thoracic aortic aneurysms has evolved over the past few years and has significantly reduced the morbidity of aortic aneurysm repair...

  • Functional Outcome After Primary Endovascular Therapy or IV Thrombolysis Alone for Stroke. An Observational, Comparative Effectiveness Study. abilleira, Sònia; Ribera, aida; Dávalos, antonio; Ribó, Marc; Chamorro, angel; Cardona, Pere; Molina, Carlos a.; Martínez-Yélamos, antonio; Urra, Xabier; Dorado, Laura; Roquer, Jaume; Martí-Fàbregas, Joan; aja, Lucía; Tomasello, alejandro; Castaño, Carlos; Blasco, Jordi; Cánovas, David; Castellanos, Mar; Krupinski, Jerzy; Guimaraens, Leopoldo // Cerebrovascular Diseases;Dec2014, Vol. 38 Issue 5, p328 

    Background: Among the acute ischemic stroke patients with large vessel occlusions and contraindications for the use of IV thrombolysis, mainly on oral anticoagulation or presenting too late, primary endovascular therapy is often performed as an alternative to the standard therapy even though...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics