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Venous Outflow Profiles Are Linked to Clinical Outcomes in Ischemic Stroke Patients with Extensive Baseline Infarct

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Venous Outflow Profiles Are Linked to Clinical Outcomes in Ischemic Stroke Patients with Extensive Baseline Infarct. / Winkelmeier, Laurens; Broocks, Gabriel; Kniep, Helge; Geest, Vincent; Reinwald, Jonathan; Meyer, Lukas; Horn, Noel van; Guenego, Adrien; Zeleňák, Kamil; Albers, Gregory W.; Lansberg, Maarten; Sporns, Peter; Wintermark, Max; Fiehler, Jens; Heit, Jeremy J.; Faizy, Tobias D.

In: J STROKE, Vol. 24, No. 3, 30.09.2022, p. 372-382.

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

Harvard

Winkelmeier, L, Broocks, G, Kniep, H, Geest, V, Reinwald, J, Meyer, L, Horn, NV, Guenego, A, Zeleňák, K, Albers, GW, Lansberg, M, Sporns, P, Wintermark, M, Fiehler, J, Heit, JJ & Faizy, TD 2022, 'Venous Outflow Profiles Are Linked to Clinical Outcomes in Ischemic Stroke Patients with Extensive Baseline Infarct', J STROKE, vol. 24, no. 3, pp. 372-382. https://doi.org/10.5853/jos.2022.01046

APA

Winkelmeier, L., Broocks, G., Kniep, H., Geest, V., Reinwald, J., Meyer, L., Horn, N. V., Guenego, A., Zeleňák, K., Albers, G. W., Lansberg, M., Sporns, P., Wintermark, M., Fiehler, J., Heit, J. J., & Faizy, T. D. (2022). Venous Outflow Profiles Are Linked to Clinical Outcomes in Ischemic Stroke Patients with Extensive Baseline Infarct. J STROKE, 24(3), 372-382. https://doi.org/10.5853/jos.2022.01046

Vancouver

Winkelmeier L, Broocks G, Kniep H, Geest V, Reinwald J, Meyer L et al. Venous Outflow Profiles Are Linked to Clinical Outcomes in Ischemic Stroke Patients with Extensive Baseline Infarct. J STROKE. 2022 Sep 30;24(3):372-382. https://doi.org/10.5853/jos.2022.01046

Bibtex

@article{63e65e1edafb4d02869c9220023282f0,
title = "Venous Outflow Profiles Are Linked to Clinical Outcomes in Ischemic Stroke Patients with Extensive Baseline Infarct",
abstract = "BACKGROUND AND PURPOSE: The benefit of endovascular thrombectomy (EVT) treatment is still unclear in stroke patients presenting with extensive baseline infarct. The use of additional imaging biomarkers could improve clinical outcome prediction and individualized EVT selection in this vulnerable cohort. We hypothesized that cerebral venous outflow (VO) may be associated with functional outcomes in patients with low Alberta Stroke Program Early CT Score (ASPECTS).METHODS: We conducted a retrospective multicenter cohort study of patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). Extensive baseline infarct was defined by an ASPECTS of ≤5 on admission computed tomography (CT). VO profiles were assessed on admission CT angiography using the Cortical Vein Opacification Score (COVES). Favorable VO was defined as COVES ≥3. Multivariable logistic regression was used to determine the association between cerebral VO and good clinical outcomes (90-day modified Rankin Scale score of ≤3).RESULTS: A total of 98 patients met the inclusion criteria. Patients with extensive baseline infarct and favorable VO achieved significantly more often good clinical outcomes compared to patients with unfavorable VO (45.5% vs. 10.5%, P<0.001). Higher COVES were strongly associated with good clinical outcomes (odds ratio, 2.17; 95% confidence interval, 1.15 to 4.57; P=0.024), independent of ASPECTS, National Institutes of Health Stroke Scale, and success of EVT.CONCLUSIONS: Cerebral VO profiles are associated with good clinical outcomes in AIS-LVO patients with extensive baseline infarct. VO profiles could serve as a useful additional imaging biomarker for treatment selection and outcome prediction in low ASPECTS patients.",
author = "Laurens Winkelmeier and Gabriel Broocks and Helge Kniep and Vincent Geest and Jonathan Reinwald and Lukas Meyer and Horn, {Noel van} and Adrien Guenego and Kamil Zele{\v n}{\'a}k and Albers, {Gregory W.} and Maarten Lansberg and Peter Sporns and Max Wintermark and Jens Fiehler and Heit, {Jeremy J.} and Faizy, {Tobias D.}",
year = "2022",
month = sep,
day = "30",
doi = "10.5853/jos.2022.01046",
language = "English",
volume = "24",
pages = "372--382",
journal = "J STROKE",
issn = "2287-6391",
publisher = "Korean Stroke Society",
number = "3",

}

RIS

TY - JOUR

T1 - Venous Outflow Profiles Are Linked to Clinical Outcomes in Ischemic Stroke Patients with Extensive Baseline Infarct

AU - Winkelmeier, Laurens

AU - Broocks, Gabriel

AU - Kniep, Helge

AU - Geest, Vincent

AU - Reinwald, Jonathan

AU - Meyer, Lukas

AU - Horn, Noel van

AU - Guenego, Adrien

AU - Zeleňák, Kamil

AU - Albers, Gregory W.

AU - Lansberg, Maarten

AU - Sporns, Peter

AU - Wintermark, Max

AU - Fiehler, Jens

AU - Heit, Jeremy J.

AU - Faizy, Tobias D.

PY - 2022/9/30

Y1 - 2022/9/30

N2 - BACKGROUND AND PURPOSE: The benefit of endovascular thrombectomy (EVT) treatment is still unclear in stroke patients presenting with extensive baseline infarct. The use of additional imaging biomarkers could improve clinical outcome prediction and individualized EVT selection in this vulnerable cohort. We hypothesized that cerebral venous outflow (VO) may be associated with functional outcomes in patients with low Alberta Stroke Program Early CT Score (ASPECTS).METHODS: We conducted a retrospective multicenter cohort study of patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). Extensive baseline infarct was defined by an ASPECTS of ≤5 on admission computed tomography (CT). VO profiles were assessed on admission CT angiography using the Cortical Vein Opacification Score (COVES). Favorable VO was defined as COVES ≥3. Multivariable logistic regression was used to determine the association between cerebral VO and good clinical outcomes (90-day modified Rankin Scale score of ≤3).RESULTS: A total of 98 patients met the inclusion criteria. Patients with extensive baseline infarct and favorable VO achieved significantly more often good clinical outcomes compared to patients with unfavorable VO (45.5% vs. 10.5%, P<0.001). Higher COVES were strongly associated with good clinical outcomes (odds ratio, 2.17; 95% confidence interval, 1.15 to 4.57; P=0.024), independent of ASPECTS, National Institutes of Health Stroke Scale, and success of EVT.CONCLUSIONS: Cerebral VO profiles are associated with good clinical outcomes in AIS-LVO patients with extensive baseline infarct. VO profiles could serve as a useful additional imaging biomarker for treatment selection and outcome prediction in low ASPECTS patients.

AB - BACKGROUND AND PURPOSE: The benefit of endovascular thrombectomy (EVT) treatment is still unclear in stroke patients presenting with extensive baseline infarct. The use of additional imaging biomarkers could improve clinical outcome prediction and individualized EVT selection in this vulnerable cohort. We hypothesized that cerebral venous outflow (VO) may be associated with functional outcomes in patients with low Alberta Stroke Program Early CT Score (ASPECTS).METHODS: We conducted a retrospective multicenter cohort study of patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). Extensive baseline infarct was defined by an ASPECTS of ≤5 on admission computed tomography (CT). VO profiles were assessed on admission CT angiography using the Cortical Vein Opacification Score (COVES). Favorable VO was defined as COVES ≥3. Multivariable logistic regression was used to determine the association between cerebral VO and good clinical outcomes (90-day modified Rankin Scale score of ≤3).RESULTS: A total of 98 patients met the inclusion criteria. Patients with extensive baseline infarct and favorable VO achieved significantly more often good clinical outcomes compared to patients with unfavorable VO (45.5% vs. 10.5%, P<0.001). Higher COVES were strongly associated with good clinical outcomes (odds ratio, 2.17; 95% confidence interval, 1.15 to 4.57; P=0.024), independent of ASPECTS, National Institutes of Health Stroke Scale, and success of EVT.CONCLUSIONS: Cerebral VO profiles are associated with good clinical outcomes in AIS-LVO patients with extensive baseline infarct. VO profiles could serve as a useful additional imaging biomarker for treatment selection and outcome prediction in low ASPECTS patients.

U2 - 10.5853/jos.2022.01046

DO - 10.5853/jos.2022.01046

M3 - SCORING: Journal article

VL - 24

SP - 372

EP - 382

JO - J STROKE

JF - J STROKE

SN - 2287-6391

IS - 3

ER -