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The negative effect of aging on cerebral venous outflow in acute ischemic stroke

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The negative effect of aging on cerebral venous outflow in acute ischemic stroke. / Heitkamp, Christian; Winkelmeier, Laurens; Heit, Jeremy J; Flottmann, Fabian; Thaler, Christian; Kniep, Helge; Broocks, Gabriel; Meyer, Lukas; Geest, Vincent; Albers, Gregory W; Lansberg, Maarten G; Fiehler, Jens; Faizy, Tobias D.

In: J CEREBR BLOOD F MET, Vol. 43, No. 10, 10.2023, p. 1648-1655.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Heitkamp, C, Winkelmeier, L, Heit, JJ, Flottmann, F, Thaler, C, Kniep, H, Broocks, G, Meyer, L, Geest, V, Albers, GW, Lansberg, MG, Fiehler, J & Faizy, TD 2023, 'The negative effect of aging on cerebral venous outflow in acute ischemic stroke', J CEREBR BLOOD F MET, vol. 43, no. 10, pp. 1648-1655. https://doi.org/10.1177/0271678X231179558

APA

Heitkamp, C., Winkelmeier, L., Heit, J. J., Flottmann, F., Thaler, C., Kniep, H., Broocks, G., Meyer, L., Geest, V., Albers, G. W., Lansberg, M. G., Fiehler, J., & Faizy, T. D. (2023). The negative effect of aging on cerebral venous outflow in acute ischemic stroke. J CEREBR BLOOD F MET, 43(10), 1648-1655. https://doi.org/10.1177/0271678X231179558

Vancouver

Heitkamp C, Winkelmeier L, Heit JJ, Flottmann F, Thaler C, Kniep H et al. The negative effect of aging on cerebral venous outflow in acute ischemic stroke. J CEREBR BLOOD F MET. 2023 Oct;43(10):1648-1655. https://doi.org/10.1177/0271678X231179558

Bibtex

@article{582fa5fef67e46fab0598b4de1bbab91,
title = "The negative effect of aging on cerebral venous outflow in acute ischemic stroke",
abstract = "Cortical venous outflow (VO) represents an imaging biomarker of increasing interest in patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). We conducted a retrospective multicenter cohort study to investigate the effect of aging on VO. A total of 784 patients met the inclusion criteria. Cortical Vein Opacification Score (COVES) was used to assess VO profiles on admission CT angiography. Cerebral microperfusion was determined using the hypoperfusion intensity ratio (HIR) derived from perfusion imaging. Arterial collaterals were assessed using the Tan scale. Multivariable regression analysis was performed to identify independent determinants of VO, HIR and arterial collaterals. In multivariable regression, higher age correlated with worse VO (adjusted odds ratio [95% CI]; 0.83 [0.73-0.95]; P = 0.006) and poorer HIR (β coefficient [95% CI], 0.014 [0.005-0.024]; P = 0.002). The negative effect of higher age on VO was mediated by the extent of HIR (17.3%). We conclude that higher age was associated with worse VO in AIS-LVO, partially explained by the extent of HIR reflecting cerebral microperfusion. Our study underlines the need to assess collateral blood flow beyond the arterial system and provides valuable insights into deteriorated cerebral blood supply in elderly AIS-LVO patients.",
keywords = "Humans, Aged, Stroke/diagnostic imaging, Ischemic Stroke, Cohort Studies, Aging, Cerebral Veins/diagnostic imaging, Retrospective Studies, Brain Ischemia/diagnostic imaging, Cerebral Angiography/methods",
author = "Christian Heitkamp and Laurens Winkelmeier and Heit, {Jeremy J} and Fabian Flottmann and Christian Thaler and Helge Kniep and Gabriel Broocks and Lukas Meyer and Vincent Geest and Albers, {Gregory W} and Lansberg, {Maarten G} and Jens Fiehler and Faizy, {Tobias D}",
year = "2023",
month = oct,
doi = "10.1177/0271678X231179558",
language = "English",
volume = "43",
pages = "1648--1655",
journal = "J CEREBR BLOOD F MET",
issn = "0271-678X",
publisher = "SAGE Publications",
number = "10",

}

RIS

TY - JOUR

T1 - The negative effect of aging on cerebral venous outflow in acute ischemic stroke

AU - Heitkamp, Christian

AU - Winkelmeier, Laurens

AU - Heit, Jeremy J

AU - Flottmann, Fabian

AU - Thaler, Christian

AU - Kniep, Helge

AU - Broocks, Gabriel

AU - Meyer, Lukas

AU - Geest, Vincent

AU - Albers, Gregory W

AU - Lansberg, Maarten G

AU - Fiehler, Jens

AU - Faizy, Tobias D

PY - 2023/10

Y1 - 2023/10

N2 - Cortical venous outflow (VO) represents an imaging biomarker of increasing interest in patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). We conducted a retrospective multicenter cohort study to investigate the effect of aging on VO. A total of 784 patients met the inclusion criteria. Cortical Vein Opacification Score (COVES) was used to assess VO profiles on admission CT angiography. Cerebral microperfusion was determined using the hypoperfusion intensity ratio (HIR) derived from perfusion imaging. Arterial collaterals were assessed using the Tan scale. Multivariable regression analysis was performed to identify independent determinants of VO, HIR and arterial collaterals. In multivariable regression, higher age correlated with worse VO (adjusted odds ratio [95% CI]; 0.83 [0.73-0.95]; P = 0.006) and poorer HIR (β coefficient [95% CI], 0.014 [0.005-0.024]; P = 0.002). The negative effect of higher age on VO was mediated by the extent of HIR (17.3%). We conclude that higher age was associated with worse VO in AIS-LVO, partially explained by the extent of HIR reflecting cerebral microperfusion. Our study underlines the need to assess collateral blood flow beyond the arterial system and provides valuable insights into deteriorated cerebral blood supply in elderly AIS-LVO patients.

AB - Cortical venous outflow (VO) represents an imaging biomarker of increasing interest in patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). We conducted a retrospective multicenter cohort study to investigate the effect of aging on VO. A total of 784 patients met the inclusion criteria. Cortical Vein Opacification Score (COVES) was used to assess VO profiles on admission CT angiography. Cerebral microperfusion was determined using the hypoperfusion intensity ratio (HIR) derived from perfusion imaging. Arterial collaterals were assessed using the Tan scale. Multivariable regression analysis was performed to identify independent determinants of VO, HIR and arterial collaterals. In multivariable regression, higher age correlated with worse VO (adjusted odds ratio [95% CI]; 0.83 [0.73-0.95]; P = 0.006) and poorer HIR (β coefficient [95% CI], 0.014 [0.005-0.024]; P = 0.002). The negative effect of higher age on VO was mediated by the extent of HIR (17.3%). We conclude that higher age was associated with worse VO in AIS-LVO, partially explained by the extent of HIR reflecting cerebral microperfusion. Our study underlines the need to assess collateral blood flow beyond the arterial system and provides valuable insights into deteriorated cerebral blood supply in elderly AIS-LVO patients.

KW - Humans

KW - Aged

KW - Stroke/diagnostic imaging

KW - Ischemic Stroke

KW - Cohort Studies

KW - Aging

KW - Cerebral Veins/diagnostic imaging

KW - Retrospective Studies

KW - Brain Ischemia/diagnostic imaging

KW - Cerebral Angiography/methods

U2 - 10.1177/0271678X231179558

DO - 10.1177/0271678X231179558

M3 - SCORING: Journal article

C2 - 37254736

VL - 43

SP - 1648

EP - 1655

JO - J CEREBR BLOOD F MET

JF - J CEREBR BLOOD F MET

SN - 0271-678X

IS - 10

ER -