Detailed Information on Publication Record
2020
Prevalence and Outcomes of Medium Vessel Occlusions With Discrepant Infarct Patterns
OSPEL, Johanna M., Petra CIMFLOVÁ, Martha MARKO, Arnuv MAYANK, Moiz HAFEEZ et. al.Basic information
Original name
Prevalence and Outcomes of Medium Vessel Occlusions With Discrepant Infarct Patterns
Authors
OSPEL, Johanna M. (756 Switzerland), Petra CIMFLOVÁ (203 Czech Republic, belonging to the institution), Martha MARKO (124 Canada), Arnuv MAYANK (124 Canada), Moiz HAFEEZ (124 Canada), Mohammed A. ALMEKHLAFI (124 Canada), Michael D. HILL (124 Canada), Andrew M. DEMCHUK (380 Italy), Bijoy K. MENON (124 Canada) and Mayank GOYAL (124 Canada, guarantor)
Edition
Stroke, Dallas, Lippincott Williams & Wilkins, 2020, 0039-2499
Other information
Language
English
Type of outcome
Článek v odborném periodiku
Field of Study
30201 Cardiac and Cardiovascular systems
Country of publisher
United States of America
Confidentiality degree
není předmětem státního či obchodního tajemství
References:
Impact factor
Impact factor: 7.914
RIV identification code
RIV/00216224:14110/20:00116434
Organization unit
Faculty of Medicine
UT WoS
000565641800051
Keywords in English
brain ischemia; follow-up studies; humans; prevalence; prognosis
Tags
International impact, Reviewed
Změněno: 17/9/2020 08:34, Mgr. Tereza Miškechová
Abstract
V originále
Background and Purpose: The prognosis of medium vessel occlusions (MeVOs), that is, M2/3 middle cerebral artery, A2/3 anterior cerebral artery, and P2/3 posterior cerebral artery occlusions, is generally better compared with large vessel occlusions, since brain ischemia is less extensive. However, in some MeVO patients, infarcts are seen outside the territory of the occluded vessel (MeVO with discrepant infarcts). This study aims to determine the prevalence and clinical impact of discrepant infarct patterns in acute ischemic stroke due to MeVO. Methods: We pooled data of MeVO patients from INTERRSeCT (Identifying New Approaches to Optimize Thrombus Characterization for Predicting Early Recanalization and Reperfusion With IV Alteplase and Other Treatments Using Serial CT Angiography) and PRove-IT (Precise and Rapid Assessment of Collaterals Using Multi-Phase CTA in the Triage of Patients With Acute Ischemic Stroke for IA Therapy)-2 prospective cohort studies of patients with acute ischemic stroke. The combination of occlusion location on baseline computed tomography angiography and infarct location on follow-up computed tomography/magnetic resonance imaging was used to identify MeVOs with discrepant infarct patterns. Two definitions for discrepant infarcts were applied; one was more restrictive and purely based on infarct patterns of the basal ganglia, whereas the second one took cortical infarct patterns into account. Clinical outcomes of patients with versus without discrepant infarcts were summarized using descriptive statistics. Logistic regression was performed to obtain adjusted effect size estimates for the association of discrepant infarcts and good outcome, defined as a modified Rankin Scale score of 0 to 2, and excellent outcome (modified Rankin Scale score 0-1). Results: Two hundred sixty-two patients with MeVO were included in the analysis. The prevalence of discrepant infarcts was 39.7% (definition 1) and 21.0% (definition 2). Patients with discrepant infarcts were less likely to achieve good outcome (definition 1: adjusted odds ratio, 0.48 [95% CI, 0.25-0.91]; definition 2: adjusted odds ratio, 0.47 [95% CI, 0.22-0.99]). When definition 1 was applied, patients with discrepant infarcts were also less likely to achieve excellent outcome (definition 1: adjusted odds ratio, 0.55 [95% CI, 0.31-0.99]; definition 2: adjusted odds ratio, 0.62 [95% CI, 0.31-1.25]). Conclusions: MeVO patients with discrepant infarcts are common, and they are associated with more severe deficits and poor outcomes.