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Effect of Oxygen Extraction (Brush-Sign) on Baseline Core Infarct Depends on Collaterals (HIR)

Standard

Effect of Oxygen Extraction (Brush-Sign) on Baseline Core Infarct Depends on Collaterals (HIR). / Guenego, Adrien; Leipzig, Matthew; Fahed, Robert; Sussman, Eric S; Faizy, Tobias D; Martin, Blake W; Marcellus, David G; Wintermark, Max; Olivot, Jean-Marc; Albers, Gregory W; Lansberg, Maarten G; Heit, Jeremy J.

in: FRONT NEUROL, Jahrgang 11, 618765, 2020.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Guenego, A, Leipzig, M, Fahed, R, Sussman, ES, Faizy, TD, Martin, BW, Marcellus, DG, Wintermark, M, Olivot, J-M, Albers, GW, Lansberg, MG & Heit, JJ 2020, 'Effect of Oxygen Extraction (Brush-Sign) on Baseline Core Infarct Depends on Collaterals (HIR)', FRONT NEUROL, Jg. 11, 618765. https://doi.org/10.3389/fneur.2020.618765

APA

Guenego, A., Leipzig, M., Fahed, R., Sussman, E. S., Faizy, T. D., Martin, B. W., Marcellus, D. G., Wintermark, M., Olivot, J-M., Albers, G. W., Lansberg, M. G., & Heit, J. J. (2020). Effect of Oxygen Extraction (Brush-Sign) on Baseline Core Infarct Depends on Collaterals (HIR). FRONT NEUROL, 11, [618765]. https://doi.org/10.3389/fneur.2020.618765

Vancouver

Guenego A, Leipzig M, Fahed R, Sussman ES, Faizy TD, Martin BW et al. Effect of Oxygen Extraction (Brush-Sign) on Baseline Core Infarct Depends on Collaterals (HIR). FRONT NEUROL. 2020;11. 618765. https://doi.org/10.3389/fneur.2020.618765

Bibtex

@article{05a9f69deaa348d7a526612d58f013fe,
title = "Effect of Oxygen Extraction (Brush-Sign) on Baseline Core Infarct Depends on Collaterals (HIR)",
abstract = "Objectives: Baseline-core-infarct volume is a critical factor in patient selection and outcome in acute ischemic stroke (AIS) before mechanical thrombectomy (MT). We determined whether oxygen extraction efficiency and arterial collaterals, two different physiologic components of the cerebral ischemic cascade, interacted to modulate baseline-core-infarct volume in patients with AIS-LVO undergoing MT triage. Methods: Between January 2015 and March 2018, consecutive patients with an AIS and M1 occlusion considered for MT with a baseline MRI and perfusion-imaging were included. Variables such as baseline-core-infarct volume [mL], arterial collaterals (HIR: TMax > 10 s volume/TMax > 6 s), high oxygen extraction (HOE, presence of the brush-sign on T2*) were assessed. A linear-regression was used to test the interaction of HOE and HIR with baseline-core-infarct volume, after including potential confounding variables. Results: We included 103 patients. Median age was 70 (58-78), and 63% were female. Median baseline-core-infarct volume was 32 ml (IQR 8-74.5). Seventy six patients (74%) had HOE. In a multivariate analysis both favorable HIR collaterals (p = 0.02) and HOE (p = 0.038) were associated with lower baseline-core-infarct volume. However, HOE significantly interacted with HIR (p = 0.01) to predict baseline-core-infarct volume, favorable collaterals (low HIR) with HOE was associated with small baseline-core-infarct whereas patients with poor collaterals (high HIR) and HOE had large baseline-core-infarct. Conclusion: While HOE under effective collateral blood-flow has the lowest baseline-core-infarct volume of all patients, the protective effect of HOE reverses under poor collateral blood-flow and may be a maladaptive response to ischemic stroke as measured by core infarctions in AIS-LVO patients undergoing MT triage.",
author = "Adrien Guenego and Matthew Leipzig and Robert Fahed and Sussman, {Eric S} and Faizy, {Tobias D} and Martin, {Blake W} and Marcellus, {David G} and Max Wintermark and Jean-Marc Olivot and Albers, {Gregory W} and Lansberg, {Maarten G} and Heit, {Jeremy J}",
note = "Copyright {\textcopyright} 2021 Guenego, Leipzig, Fahed, Sussman, Faizy, Martin, Marcellus, Wintermark, Olivot, Albers, Lansberg and Heit.",
year = "2020",
doi = "10.3389/fneur.2020.618765",
language = "English",
volume = "11",
journal = "FRONT NEUROL",
issn = "1664-2295",
publisher = "Frontiers Research Foundation",

}

RIS

TY - JOUR

T1 - Effect of Oxygen Extraction (Brush-Sign) on Baseline Core Infarct Depends on Collaterals (HIR)

AU - Guenego, Adrien

AU - Leipzig, Matthew

AU - Fahed, Robert

AU - Sussman, Eric S

AU - Faizy, Tobias D

AU - Martin, Blake W

AU - Marcellus, David G

AU - Wintermark, Max

AU - Olivot, Jean-Marc

AU - Albers, Gregory W

AU - Lansberg, Maarten G

AU - Heit, Jeremy J

N1 - Copyright © 2021 Guenego, Leipzig, Fahed, Sussman, Faizy, Martin, Marcellus, Wintermark, Olivot, Albers, Lansberg and Heit.

PY - 2020

Y1 - 2020

N2 - Objectives: Baseline-core-infarct volume is a critical factor in patient selection and outcome in acute ischemic stroke (AIS) before mechanical thrombectomy (MT). We determined whether oxygen extraction efficiency and arterial collaterals, two different physiologic components of the cerebral ischemic cascade, interacted to modulate baseline-core-infarct volume in patients with AIS-LVO undergoing MT triage. Methods: Between January 2015 and March 2018, consecutive patients with an AIS and M1 occlusion considered for MT with a baseline MRI and perfusion-imaging were included. Variables such as baseline-core-infarct volume [mL], arterial collaterals (HIR: TMax > 10 s volume/TMax > 6 s), high oxygen extraction (HOE, presence of the brush-sign on T2*) were assessed. A linear-regression was used to test the interaction of HOE and HIR with baseline-core-infarct volume, after including potential confounding variables. Results: We included 103 patients. Median age was 70 (58-78), and 63% were female. Median baseline-core-infarct volume was 32 ml (IQR 8-74.5). Seventy six patients (74%) had HOE. In a multivariate analysis both favorable HIR collaterals (p = 0.02) and HOE (p = 0.038) were associated with lower baseline-core-infarct volume. However, HOE significantly interacted with HIR (p = 0.01) to predict baseline-core-infarct volume, favorable collaterals (low HIR) with HOE was associated with small baseline-core-infarct whereas patients with poor collaterals (high HIR) and HOE had large baseline-core-infarct. Conclusion: While HOE under effective collateral blood-flow has the lowest baseline-core-infarct volume of all patients, the protective effect of HOE reverses under poor collateral blood-flow and may be a maladaptive response to ischemic stroke as measured by core infarctions in AIS-LVO patients undergoing MT triage.

AB - Objectives: Baseline-core-infarct volume is a critical factor in patient selection and outcome in acute ischemic stroke (AIS) before mechanical thrombectomy (MT). We determined whether oxygen extraction efficiency and arterial collaterals, two different physiologic components of the cerebral ischemic cascade, interacted to modulate baseline-core-infarct volume in patients with AIS-LVO undergoing MT triage. Methods: Between January 2015 and March 2018, consecutive patients with an AIS and M1 occlusion considered for MT with a baseline MRI and perfusion-imaging were included. Variables such as baseline-core-infarct volume [mL], arterial collaterals (HIR: TMax > 10 s volume/TMax > 6 s), high oxygen extraction (HOE, presence of the brush-sign on T2*) were assessed. A linear-regression was used to test the interaction of HOE and HIR with baseline-core-infarct volume, after including potential confounding variables. Results: We included 103 patients. Median age was 70 (58-78), and 63% were female. Median baseline-core-infarct volume was 32 ml (IQR 8-74.5). Seventy six patients (74%) had HOE. In a multivariate analysis both favorable HIR collaterals (p = 0.02) and HOE (p = 0.038) were associated with lower baseline-core-infarct volume. However, HOE significantly interacted with HIR (p = 0.01) to predict baseline-core-infarct volume, favorable collaterals (low HIR) with HOE was associated with small baseline-core-infarct whereas patients with poor collaterals (high HIR) and HOE had large baseline-core-infarct. Conclusion: While HOE under effective collateral blood-flow has the lowest baseline-core-infarct volume of all patients, the protective effect of HOE reverses under poor collateral blood-flow and may be a maladaptive response to ischemic stroke as measured by core infarctions in AIS-LVO patients undergoing MT triage.

U2 - 10.3389/fneur.2020.618765

DO - 10.3389/fneur.2020.618765

M3 - SCORING: Journal article

C2 - 33488506

VL - 11

JO - FRONT NEUROL

JF - FRONT NEUROL

SN - 1664-2295

M1 - 618765

ER -