Titre :

Determinants of Infarct Core Growth During Inter-hospital Transfer for Thrombectomy.

Auteur(s) :

Seners, Pierre [Auteur]
Scheldeman, Lauranne [Auteur]
Christensen, Soren [Auteur]
Mlynash, Michael [Auteur]
Ter Schiphorst, Adrien [Auteur]
Arquizan, Caroline [Auteur]
Costalat, Vincent [Auteur]
Henon, Hilde [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Bretzner, Martin [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Heit, Jeremy J. [Auteur]
Olivot, Jean-Marc [Auteur]
Lansberg, Maarten G. [Auteur]
Albers, Gregory W. [Auteur]

Titre de la revue :

Annals of Neurology

Nom court de la revue :

Ann Neurol

Numéro :

93

Pagination :

1117-1129

Date de publication :

2023-06

ISSN :

1531-8249

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Objective Patients with acute ischemic stroke harboring a large vessel occlusion who present to primary stroke centers often require inter-hospital transfer for thrombectomy. We aimed to determine clinical and imaging ...
Lire la suite >Objective Patients with acute ischemic stroke harboring a large vessel occlusion who present to primary stroke centers often require inter-hospital transfer for thrombectomy. We aimed to determine clinical and imaging factors independently associated with fast infarct growth (IG) during inter-hospital transfer. Methods We retrospectively analyzed data from acute stroke patients with a large vessel occlusion transferred for thrombectomy from a primary stroke center to one of three French comprehensive stroke centers, with an MRI obtained at both the primary and comprehensive center before thrombectomy. Inter-hospital IG rate was defined as the difference in infarct volumes on diffusion-weighted imaging between the primary and comprehensive center, divided by the delay between the two MRI scans. The primary outcome was identification of fast progressors, defined as IG rate ≥5 mL/hour. The hypoperfusion intensity ratio (HIR), a surrogate marker of collateral blood flow, was automatically measured on perfusion imaging. Results A total of 233 patients were included, of whom 27% patients were fast progressors. The percentage of fast progressors was 3% among patients with HIR < 0.40 and 71% among those with HIR ≥ 0.40. In multivariable analysis, fast progression was independently associated with HIR, intracranial carotid artery occlusion, and exclusively deep infarct location at the primary center (C-statistic = 0.95; 95% confidence interval [CI], 0.93–0.98). IG rate was independently associated with good functional outcome (adjusted OR = 0.91; 95% CI, 0.83–0.99; P = 0.037). Interpretation Our findings show that a HIR > 0.40 is a powerful indicator of fast inter-hospital IG. These results have implication for neuroprotection trial design, as well as informing triage decisions at primary stroke centers. ANN NEUROL 2023;93:1117–1129Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Date de dépôt :

2024-01-15T23:48:31Z
2024-12-11T13:01:25Z