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Association of Cortical Vein Filling with Clot Location and Clinical Outcomes in Acute Ischaemic Stroke Patients

Artikel i vetenskaplig tidskrift
Författare S. Bhaskar
A. Bivard
P. Stanwell
J. R. Attia
M. Parsons
Michael Nilsson
C. Levi
Publicerad i Scientific Reports
Volym 6
ISSN 2045-2322
Publiceringsår 2016
Publicerad vid Institutionen för neurovetenskap och fysiologi
Språk en
Länkar dx.doi.org/10.1038/srep38525
Ämnesord middle cerebral-artery, internal carotid-artery, ct angiography, mechanical thrombectomy, anterior circulation, intraarterial, thrombolysis, computed-tomography, intravenous thrombolysis, leptomeningeal collaterals, endovascular therapy, Science & Technology - Other Topics
Ämneskategorier Neurovetenskaper

Sammanfattning

Delay in cortical vein filling during the late-venous phase (delayed-LCVF) is characterized by opacification of cerebral veins despite contrast clearance from contralateral veins on dynamic computed tomography angiography (dCTA) in acute ischemic stroke (AIS) patients. The aim of the study was to investigate the associations of delayed-LCVF with clot location, reperfusion status at 24 hours, and 90-days functional outcome in AIS patients who received reperfusion therapy. A prospective cohort of AIS patients treated with intravenous thrombolysis was studied. Groupwise comparison, univariate, and multivariate regression analyses were used to study the association of delayed-LCVF with clot location and clinical outcomes. Of 93 patients (mean age = 72 +/- 12 years) with hemispheric AIS included in the study, 46 (49%) demonstrated delayed-LCVF. Patients with delayed-LCVF demonstrated a significantly higher proportion of proximal occlusion (72% vs 13%, P =<0.0001), and poor reperfusion at 24 hours (41% vs 11%, P = 0.001). The proportion of poor functional outcome at 90 days was not significantly different (22/56 (48%) vs 17/61 (36%), P = 0.297). The appearance of delayed-LCVF on baseline dCTA may be a surrogate for large vessel occlusion, and an early marker for poor 24-hour angiographic reperfusion.

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