Alexander H Nave1, Anna Kufner2, Philipp Bücke2, Eberhard Siebert2, Stefan Kliesch2, Ulrike Grittner2, Hansjörg Bäzner2, Thomas Liebig2, Matthias Endres2, Jochen B Fiebach2, Christian H Nolte2, Martin Ebinger2, Hans Henkes2. 1. From the Center for Stroke Research Berlin (A.H.N., A.K., U.G., M. Endres, J.B.F., C.H.N., M. Ebinger), Klinik und Hochschulambulanz für Neurologie (A.H.N., M. Endres, C.H.N.), Institut für Neuroradiologie (E.S., S.K., T.L., J.B.F.), and Department of Biostatistics and Clinical Epidemiology (U.G.), Charité-Universitätsmedizin Berlin, Germany; German Center for Cardiovascular Research (A.H.N., M. Endres,) and German Center for Neurodegenerative Disease (M. Endres), partner site Berlin; Berlin Institute of Health, Germany (A.H.N., M. Endres, C.H.N.); Neurologische Klinik (P.B., H.B.) and Klinik für diagnostische und interventionelle Neuroradiologie (H.H.), Klinikum Stuttgart, Germany; Psychiatrische Universitätsklinik Zürich, Switzerland (P.B.); and Medical Park Berlin Humboldtmühle, Neurologische Klinik, Germany (M. Ebinger). alexander.nave@charite.de. 2. From the Center for Stroke Research Berlin (A.H.N., A.K., U.G., M. Endres, J.B.F., C.H.N., M. Ebinger), Klinik und Hochschulambulanz für Neurologie (A.H.N., M. Endres, C.H.N.), Institut für Neuroradiologie (E.S., S.K., T.L., J.B.F.), and Department of Biostatistics and Clinical Epidemiology (U.G.), Charité-Universitätsmedizin Berlin, Germany; German Center for Cardiovascular Research (A.H.N., M. Endres,) and German Center for Neurodegenerative Disease (M. Endres), partner site Berlin; Berlin Institute of Health, Germany (A.H.N., M. Endres, C.H.N.); Neurologische Klinik (P.B., H.B.) and Klinik für diagnostische und interventionelle Neuroradiologie (H.H.), Klinikum Stuttgart, Germany; Psychiatrische Universitätsklinik Zürich, Switzerland (P.B.); and Medical Park Berlin Humboldtmühle, Neurologische Klinik, Germany (M. Ebinger).
Abstract
BACKGROUND AND PURPOSE: Fluid-attenuated inversion recovery hyperintense vessels (FHV) are frequently observed on magnetic resonance imaging in acute stroke patients with proximal vessel occlusion. Whether FHV can serve as a surrogate for the collateral status and predict functional outcome of patients is still a matter of debate. METHODS: Acute ischemic stroke patients with M1-middle cerebral artery occlusion who received magnetic resonance imaging before endovascular treatment in 3 hospitals in Germany between January 2007 and June 2016 were eligible. Quantification of FHV was performed using an FHV-Alberta Stroke Program Early CT Score (ASPECTS) rating system. Functional outcome was evaluated with the modified Rankin Scale 3 months after stroke. Collateral status of patients was graded on baseline angiography using the American Society of Interventional and Therapeutic Neuroradiology grading system. Odds for good outcome (modified Rankin Scale score, 0-2) were determined using logistic regression analyses. RESULTS: Overall, 116 patients were analyzed (median age, 74; interquartile range [IQR], 64-79; median National Institutes of Health Stroke Scale, 14; IQR, 10-19). The median FHV-ASPECTS was 2 (IQR, 1-3). Good collateral status (American Society of Interventional and Therapeutic Neuroradiology grade 3-4) on angiography was more frequently observed in patients with FHV-ASPECTS ≤2 (83% versus 57%; P=0.025). Patients with an FHV-ASPECTS ≤2 had a better functional outcome after 3 months (median modified Rankin Scale score, 2; IQR, 0-5), compared with patients with an FHV-ASPECTS >2 (median modified Rankin Scale score, 4; IQR, 3-6; P=0.015). In multiple regression analyses, FHV-ASPECTS ≤2 was independently associated with good functional outcome (adjusted odds ratio, 5.3; 95% confidence interval, 1.5-18.2). CONCLUSIONS: Low FHV-ASPECTS is associated with both better collateral status and better 3-month functional outcome in acute stroke patients with M1 vessel occlusion.
BACKGROUND AND PURPOSE: Fluid-attenuated inversion recovery hyperintense vessels (FHV) are frequently observed on magnetic resonance imaging in acute strokepatients with proximal vessel occlusion. Whether FHV can serve as a surrogate for the collateral status and predict functional outcome of patients is still a matter of debate. METHODS: Acute ischemic strokepatients with M1-middle cerebral artery occlusion who received magnetic resonance imaging before endovascular treatment in 3 hospitals in Germany between January 2007 and June 2016 were eligible. Quantification of FHV was performed using an FHV-Alberta Stroke Program Early CT Score (ASPECTS) rating system. Functional outcome was evaluated with the modified Rankin Scale 3 months after stroke. Collateral status of patients was graded on baseline angiography using the American Society of Interventional and Therapeutic Neuroradiology grading system. Odds for good outcome (modified Rankin Scale score, 0-2) were determined using logistic regression analyses. RESULTS: Overall, 116 patients were analyzed (median age, 74; interquartile range [IQR], 64-79; median National Institutes of Health Stroke Scale, 14; IQR, 10-19). The median FHV-ASPECTS was 2 (IQR, 1-3). Good collateral status (American Society of Interventional and Therapeutic Neuroradiology grade 3-4) on angiography was more frequently observed in patients with FHV-ASPECTS ≤2 (83% versus 57%; P=0.025). Patients with an FHV-ASPECTS ≤2 had a better functional outcome after 3 months (median modified Rankin Scale score, 2; IQR, 0-5), compared with patients with an FHV-ASPECTS >2 (median modified Rankin Scale score, 4; IQR, 3-6; P=0.015). In multiple regression analyses, FHV-ASPECTS ≤2 was independently associated with good functional outcome (adjusted odds ratio, 5.3; 95% confidence interval, 1.5-18.2). CONCLUSIONS: Low FHV-ASPECTS is associated with both better collateral status and better 3-month functional outcome in acute strokepatients with M1 vessel occlusion.
Authors: I Derraz; M Pou; J Labreuche; L Legrand; S Soize; M Tisserand; C Rosso; M Piotin; G Boulouis; C Oppenheim; O Naggara; S Bracard; F Clarençon; B Lapergue; R Bourcier Journal: AJNR Am J Neuroradiol Date: 2020-11-12 Impact factor: 3.825
Authors: Dai-Shi Tian; Chuan Qin; Luo-Qi Zhou; Sheng Yang; Man Chen; Jun Xiao; Ke Shang; Dale B Bosco; Long-Jun Wu; Wei Wang Journal: Signal Transduct Target Ther Date: 2022-01-07
Authors: Nolwenn Riou-Comte; Benjamin Gory; Marc Soudant; François Zhu; Yu Xie; Lisa Humbertjean; Gioia Mione; Catherine Oppenheim; Francis Guillemin; Serge Bracard; Sébastien Richard Journal: Stroke Vasc Neurol Date: 2021-06-08