Impact of MRI Selection on Triage of Endovascular Therapy in Acute Ischemic Stroke: The MRI in Acute Management of Ischemic Stroke (MIAMIS) Registry

Interventional Neurology
Kunakorn AtchaneeyasakulDileep Yavagal

Abstract

The recently published multicenter randomized DAWN trial confirmed greater outcome benefit of endovascular therapy (ET) for anterior circulation large vessel occlusion ischemic stroke from 6 to 24 h from symptom onset compared to medical management in patients selected by advanced imaging with MRI or perfusion CT to identify mismatch between clinical deficit and infarct volume, which represents salvageable penumbra. The debate of CT over MRI is usually the potentially increase time consumption and the difficulty in establishing an adequate standardized workflow utilizing MRI during the hyperacute phase. While CT-based selection of patients is the current standard of care, we sought to determine the time impact of the alternative approach of MRI selection in the 0-12 h window. In the MRI in Acute Management of Ischemic Stroke (MIAMIS) registry, we retrospectively analyzed 89 consecutive patients from January 2008 to January 2010 who presented with acute stroke symptoms with a National Institutes of Health Stroke Scale score ≥5 or aphasia within 0-12 h from symptom onset. The presence of penumbra was determined by MR perfusion-diffusion mismatch or clinical diffusion mismatch. Patients were stratified based on the presence of mis...Continue Reading

Citations

May 15, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Lyndon C BoxEhtisham Mahmud
Sep 30, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Kunakorn AtchaneeyasakulUNKNOWN UCLA Reperfusion Therapy Investigators

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