학술논문
Association of Ischemic Core Imaging Biomarkers With Post-Thrombectomy Clinical Outcomes in the MR CLEAN Registry
Document Type
article
Author
Miou S. Koopman; Jan W. Hoving; Manon Kappelhof; Olvert A. Berkhemer; Ludo F. M. Beenen; Wim H. van Zwam; Hugo W. A. M. de Jong; Jan Willem Dankbaar; Diederik W. J. Dippel; Jonathan M. Coutinho; Henk A. Marquering; Bart J. Emmer; Charles B. L. M. Majoie; for the MR CLEAN Registry Investigators; Aad van der Lugt; Yvo B. W. E. M. Roos; Robert J. van Oostenbrugge; Jelis Boiten; Jan Albert Vos; Ivo G. H. Jansen; Maxim J. H. L. Mulder; Robert-Jan B. Goldhoorn; Kars C. J. Compagne; Josje Brouwer; Sanne J. den Hartog; Wouter H. Hinsenveld; Bob Roozenbeek; Adriaan C. G. M. van Es; Wouter J. Schonewille; Marieke J. H. Wermer; Marianne A. A. van Walderveen; Julie Staals; Jeannette Hofmeijer; Jasper M. Martens; Geert J. Lycklama à Nijeholt; Sebastiaan F. de Bruijn; Lukas C. van Dijk; H. Bart van der Worp; Rob H. Lo; Ewoud J. van Dijk; Hieronymus D. Boogaarts; J. de Vries; Paul L. M. de Kort; Julia van Tuijl; Jo P. Peluso; Puck Fransen; Jan S. P. van den Berg; Boudewijn A. A. M. van Hasselt; Leo A. M. Aerden; René J. Dallinga; Maarten Uyttenboogaart; Omid Eschgi; Reinoud P.H. Bokkers; Tobien H. C. M. L. Schreuder; Roel J. J. Heijboer; Koos Keizer; Lonneke S. F. Yo; Heleen M. den Hertog; Emiel J. C. Sturm; Paul J. A. M. Brouwers; Marieke E. S. Sprengers; Sjoerd F. M. Jenniskens; René van den Berg; Albert J. Yoo; Alida A. Postma; Stefan D. Roosendaal; Bas F. W. van der Kallen; Ido R. van den Wijngaard; Joost Bot; Pieter-Jan van Doormaal; Anton Meijer; Elyas Ghariq; Reinoud P. H. Bokkers; Marc P. van Proosdij; G. Menno Krietemeijer; Rob Lo; Dick Gerrits; Wouter Dinkelaar; Auke P. A. Appelman; Bas Hammer; Sjoert Pegge; Anouk van der Hoorn; Saman Vinke; H. Zwenneke Flach; Hester F. Lingsma; Naziha el Ghannouti; Martin Sterrenberg; Wilma Pellikaan; Rita Sprengers; Marjan Elfrink; Michelle Simons; Marjolein Vossers; Joke de Meris; Tamara Vermeulen; Annet Geerlings; Gina van Vemde; Tiny Simons; Gert Messchendorp; Nynke Nicolaij; Hester Bongenaar; Karin Bodde; Sandra Kleijn; Jasmijn Lodico; Hanneke Droste; Maureen Wollaert; Sabrina Verheesen; D. Jeurrissen; Erna Bos; Yvonne Drabbe; Michelle Sandiman; Nicoline Aaldering; Berber Zweedijk; Jocova Vervoort; Eva Ponjee; Sharon Romviel; Karin Kanselaar; Denn Barning; Esmee Venema; Vicky Chalos; Ralph R. Geuskens; Tim van Straaten; Saliha Ergezen; Roger R. M. Harmsma Daan Muijres; Anouk de Jong; Anna M. M. Boers; J. Huguet; P. F. C. Groot; Marieke A. Mens; Katinka R. van Kranendonk; Kilian M. Treurniet; Manon L. Tolhuisen; Heitor Alves; Annick J. Weterings; Eleonora L. F. Kirkels; Lieve M. Schupp; Eva J. H. F. Voogd; Sabine Collette; Adrien E. D. Groot; Natalie E. LeCouffe; Praneeta R. Konduri; Haryadi Prasetya; Nerea Arrarte- Terreros; Lucas A. Ramos
Source
Frontiers in Neurology, Vol 12 (2022)
Subject
Language
English
ISSN
1664-2295
Abstract
Background: A considerable proportion of acute ischemic stroke patients treated with endovascular thrombectomy (EVT) are dead or severely disabled at 3 months despite successful reperfusion. Ischemic core imaging biomarkers may help to identify patients who are more likely to have a poor outcome after endovascular thrombectomy (EVT) despite successful reperfusion. We studied the association of CT perfusion-(CTP), CT angiography-(CTA), and non-contrast CT-(NCCT) based imaging markers with poor outcome in patients who underwent EVT in daily clinical practice.Methods: We included EVT-treated patients (July 2016–November 2017) with an anterior circulation occlusion from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry with available baseline CTP, CTA, and NCCT. We used multivariable binary and ordinal logistic regression to analyze the association of CTP ischemic core volume, CTA-Collateral Score (CTA-CS), and Alberta Stroke Program Early CT Score (ASPECTS) with poor outcome (modified Rankin Scale score (mRS) 5-6) and likelihood of having a lower score on the mRS at 90 days.Results: In 201 patients, median core volume was 13 (IQR 5-41) mL. Median ASPECTS was 9 (IQR 8-10). Most patients had grade 2 (83/201; 42%) or grade 3 (28/201; 14%) collaterals. CTP ischemic core volume was associated with poor outcome [aOR per 10 mL 1.02 (95%CI 1.01–1.04)] and lower likelihood of having a lower score on the mRS at 90 days [aOR per 10 mL 0.85 (95% CI 0.78–0.93)]. In multivariable analysis, neither CTA-CS nor ASPECTS were significantly associated with poor outcome or the likelihood of having a lower mRS.Conclusion: In our population of patients treated with EVT in daily clinical practice, CTP ischemic core volume is associated with poor outcome and lower likelihood of shift toward better outcome in contrast to either CTA-CS or ASPECTS.