Hypoperfusion ratio predicts infarct growth during transfer for thrombectomy

Annals of Neurology
Adrien GuenegoGregory Albers

Abstract

We hypothesized that automated assessment of collaterals on computed tomography perfusion can predict the rate of infarct growth during transfer from a primary to a comprehensive stroke center for endovascular stroke treatment. We identified consecutive patients (N = 28) and assessed their collaterals based on the hypoperfusion intensity ratio (HIR) prior to transfer. Infarct growth rate was strongly correlated with HIR (r = 0.78, p < 0.001). Receiver operating characteristic analysis identified HIR ≥ 0.5 as optimal for predicting infarct growth. Patients with HIR ≥ 0.5 had a median infarct growth rate of 10.1ml/h (interquartile range [IQR] = 6.4-18.4) compared with 0.9ml/h (IQR = 0-2.8; p < 0.001) in patients with HIR < 0.5. Patients with HIR ≥ 0.5 had an 83% probability of significant core growth, whereas patients with HIR < 0.5 had an 88% probability of core stability. These preliminary data have the potential to guide decision making regarding whether repeat brain imaging should be performed after transfer to a comprehensive stroke center. Ann Neurol 2018;84:616-620.

References

Dec 26, 2008·Stroke; a Journal of Cerebral Circulation·Jean-Marc OlivotGregory W Albers
Sep 8, 2012·Lancet Neurology·Maarten G LansbergUNKNOWN DEFUSE 2 study investigators
Mar 7, 2014·Stroke; a Journal of Cerebral Circulation·Jean Marc OlivotUNKNOWN DEFUSE 2 Investigators
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Apr 18, 2015·The New England Journal of Medicine·Jeffrey L SaverUNKNOWN SWIFT PRIME Investigators
Oct 18, 2015·Annals of Neurology·Gregory W AlbersJeffrey L Saver
Dec 15, 2015·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Carlo W CeredaMaarten G Lansberg
Aug 11, 2017·Stroke; a Journal of Cerebral Circulation·Marcelo Rocha, Tudor G Jovin
Nov 15, 2017·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Juan F ArenillasGregory W Albers
Jan 25, 2018·The New England Journal of Medicine·Gregory W AlbersUNKNOWN DEFUSE 3 Investigators

❮ Previous
Next ❯

Citations

Feb 9, 2019·Stroke; a Journal of Cerebral Circulation·Søren ChristensenGregory W Albers
Jan 22, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Andrew W Asimos
Mar 8, 2019·Stroke; a Journal of Cerebral Circulation·Adrien GuenegoJeremy J Heit
May 24, 2019·Stroke; a Journal of Cerebral Circulation·Natan M BornsteinUNKNOWN ImpACT-24A Investigators
Aug 21, 2019·Stroke; a Journal of Cerebral Circulation·Daniel Puhr-WesterheideWolfgang G Kunz
Aug 30, 2019·Stroke; a Journal of Cerebral Circulation·Han-Gil JeongHee-Joon Bae
Jan 18, 2020·Stroke; a Journal of Cerebral Circulation·Longting LinMark W Parsons
Feb 19, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A GuenegoJ J Heit
Sep 3, 2019·International Journal of Stroke : Official Journal of the International Stroke Society·Dylan N WolmanJeremy J Heit
Jun 23, 2020·Stroke; a Journal of Cerebral Circulation·Bruce C V Campbell
Jul 25, 2019·Frontiers in Neuroinformatics·Shengyu FanXunming Ji
Mar 21, 2019·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Pierre SenersJean-Claude Baron
Mar 13, 2020·Scientific Reports·Adrien GuenegoUNKNOWN RADON Investigators
May 10, 2020·Journal of Neurointerventional Surgery·Mahmoud H MohammadenRaul G Nogueira
Jun 20, 2020·Journal of Neurointerventional Surgery·Jeremy J HeitAlbers W Gregory
Oct 10, 2020·Brain Communications·Seena DehkharghaniRaul G Nogueira
Jan 12, 2021·Stroke; a Journal of Cerebral Circulation·Marta Olivé-GadeaMarc Ribo
Jan 26, 2021·Frontiers in Neurology·Adrien GuenegoJeremy J Heit
Feb 10, 2021·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Tobias D FaizyJeremy J Heit
Jan 19, 2021·Revue neurologique·C Garcia-EsperonJ M Olivot
Mar 9, 2021·Stroke; a Journal of Cerebral Circulation·Tobias D FaizyJeremy J Heit
Mar 9, 2021·Stroke; a Journal of Cerebral Circulation·Álvaro García-TornelMarc Ribó
Feb 19, 2021·Frontiers in Neurology·Adrien GuenegoJeremy J Heit
Apr 1, 2021·Journal of Neurointerventional Surgery·Andre MonteiroRicardo A Hanel
Aug 17, 2021·Topics in Magnetic Resonance Imaging : TMRI·Tobias Djamsched Faizy, Jeremy Josef Heit
Aug 24, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Tobias D FaizyJeremy J Heit
Sep 30, 2021·Stroke; a Journal of Cerebral Circulation·Juan F Arenillas
Oct 1, 2021·Stroke; a Journal of Cerebral Circulation·Anke WoutersRobin Lemmens
Nov 18, 2021·Annals of Neurology·Carlo W CeredaJeremy J Heit

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.