Acute reperfusion without recanalization: Serial assessment of collaterals within 6 h of using perfusion-weighted magnetic resonance imaging
Standard
Acute reperfusion without recanalization: Serial assessment of collaterals within 6 h of using perfusion-weighted magnetic resonance imaging. / Makris, Nikolaos; Chamard, Leila; Mikkelsen, Irene K; Hermier, Marc; Derex, Laurent; Pedraza, Salvador; Thomalla, Götz; Østergaard, Leif; Baron, Jean-Claude; Nighoghossian, Norbert; Berthezène, Yves; Cho, Tae-Hee.
in: J CEREBR BLOOD F MET, Jahrgang 39, Nr. 2, 02.2019, S. 251-259.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Acute reperfusion without recanalization: Serial assessment of collaterals within 6 h of using perfusion-weighted magnetic resonance imaging
AU - Makris, Nikolaos
AU - Chamard, Leila
AU - Mikkelsen, Irene K
AU - Hermier, Marc
AU - Derex, Laurent
AU - Pedraza, Salvador
AU - Thomalla, Götz
AU - Østergaard, Leif
AU - Baron, Jean-Claude
AU - Nighoghossian, Norbert
AU - Berthezène, Yves
AU - Cho, Tae-Hee
PY - 2019/2
Y1 - 2019/2
N2 - Acute reperfusion despite persistent arterial occlusion may occur in up to 30% of ischemic stroke patients. Recruitment of leptomeningeal collaterals may explain this phenomenon. Using dynamic susceptibility-contrast perfusion imaging (DSC-PI), we assessed acute changes in collateral flow among patients without recanalization. From a multicenter prospective database (I-KNOW), 46 patients with magnetic resonance angiography visible occlusion in whom both reperfusion and recanalization were assessed within 6 h of onset were identified. Maps of collateral flow at arterial, capillary and late venous phases were generated from DSC-PI through inter-frame registration, baseline signal subtraction and temporal summation, and graded blind to all other relevant clinical and radiological data using the Higashida scale. Flow direction and the acute evolution of collaterals were evaluated against the reperfusion status. Among patients without recanalization ( n = 33), flow direction remained retrograde. Collateral grades significantly improved between admission and acute follow-up in patients who reperfused (OR: 4.57; 95% CI: 1.1-22.7; p = 0.048), but not in those without reperfusion (OR: 1.34; 95% CI: 0.4-4.5; p = 0.623). Our study confirmed that acute reperfusion without recanalization is associated with a significant improvement of retrograde collateral flow. DSC-PI can detect acute changes in collateral flow, and may help evaluate novel treatments targeting leptomeningeal collaterals.
AB - Acute reperfusion despite persistent arterial occlusion may occur in up to 30% of ischemic stroke patients. Recruitment of leptomeningeal collaterals may explain this phenomenon. Using dynamic susceptibility-contrast perfusion imaging (DSC-PI), we assessed acute changes in collateral flow among patients without recanalization. From a multicenter prospective database (I-KNOW), 46 patients with magnetic resonance angiography visible occlusion in whom both reperfusion and recanalization were assessed within 6 h of onset were identified. Maps of collateral flow at arterial, capillary and late venous phases were generated from DSC-PI through inter-frame registration, baseline signal subtraction and temporal summation, and graded blind to all other relevant clinical and radiological data using the Higashida scale. Flow direction and the acute evolution of collaterals were evaluated against the reperfusion status. Among patients without recanalization ( n = 33), flow direction remained retrograde. Collateral grades significantly improved between admission and acute follow-up in patients who reperfused (OR: 4.57; 95% CI: 1.1-22.7; p = 0.048), but not in those without reperfusion (OR: 1.34; 95% CI: 0.4-4.5; p = 0.623). Our study confirmed that acute reperfusion without recanalization is associated with a significant improvement of retrograde collateral flow. DSC-PI can detect acute changes in collateral flow, and may help evaluate novel treatments targeting leptomeningeal collaterals.
KW - Journal Article
U2 - 10.1177/0271678X17744716
DO - 10.1177/0271678X17744716
M3 - SCORING: Journal article
C2 - 29291673
VL - 39
SP - 251
EP - 259
JO - J CEREBR BLOOD F MET
JF - J CEREBR BLOOD F MET
SN - 0271-678X
IS - 2
ER -