Cargando…

Outcome estimation based on multimodal computed tomography examination in acute ischaemic stroke patients treated with mechanical thrombectomy

INTRODUCTION: Reperfusion therapy for acute ischaemic stroke used within a time window of 6 h following symptom onset, although currently the treatment of choice, is characterised by certain limitations and carries certain risks. AIM: To assess the potential for predicting the risks and limitations...

Descripción completa

Detalles Bibliográficos
Autores principales: Łasocha, Bartłomiej, Brzegowy, Paweł, Słowik, Agnieszka, Latacz, Paweł, Pułyk, Roman, Popiela, Tadeusz J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939209/
https://www.ncbi.nlm.nih.gov/pubmed/31908703
http://dx.doi.org/10.5114/wiitm.2019.84761
_version_ 1783484184166137856
author Łasocha, Bartłomiej
Brzegowy, Paweł
Słowik, Agnieszka
Latacz, Paweł
Pułyk, Roman
Popiela, Tadeusz J.
author_facet Łasocha, Bartłomiej
Brzegowy, Paweł
Słowik, Agnieszka
Latacz, Paweł
Pułyk, Roman
Popiela, Tadeusz J.
author_sort Łasocha, Bartłomiej
collection PubMed
description INTRODUCTION: Reperfusion therapy for acute ischaemic stroke used within a time window of 6 h following symptom onset, although currently the treatment of choice, is characterised by certain limitations and carries certain risks. AIM: To assess the potential for predicting the risks and limitations of reperfusion therapy by means of advanced neuroimaging. MATERIAL AND METHODS: For this purpose, the baseline CT scans of patients with ischaemic stroke treated by means of mechanical thrombectomy were assessed retrospectively using the Combined Multimodal Computed Tomography Score (CMCTS), modified to account for the perfusion examination of a limited area. These data were then combined with radiological and clinical outcomes, in particular haemorrhagic stroke transformation and scoring on a modified Rankin scale (mRS). RESULTS: Based on material from 85 patients, the scoring system we employed enabled us to distinguish a group that did not benefit from treatment with specificity and a positive predictive value of 100%, and a negative predictive value of 64%. Neither the relationship between the score and early haemorrhagic complications, nor the effectiveness or severity of the course of the thrombectomy procedure itself was confirmed. CONCLUSIONS: There is no justification for the use of reperfusion procedures in acute ischaemic stroke in the anterior circulation in patients with initially unfavourable multimodal computed tomography scores.
format Online
Article
Text
id pubmed-6939209
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Termedia Publishing House
record_format MEDLINE/PubMed
spelling pubmed-69392092020-01-06 Outcome estimation based on multimodal computed tomography examination in acute ischaemic stroke patients treated with mechanical thrombectomy Łasocha, Bartłomiej Brzegowy, Paweł Słowik, Agnieszka Latacz, Paweł Pułyk, Roman Popiela, Tadeusz J. Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: Reperfusion therapy for acute ischaemic stroke used within a time window of 6 h following symptom onset, although currently the treatment of choice, is characterised by certain limitations and carries certain risks. AIM: To assess the potential for predicting the risks and limitations of reperfusion therapy by means of advanced neuroimaging. MATERIAL AND METHODS: For this purpose, the baseline CT scans of patients with ischaemic stroke treated by means of mechanical thrombectomy were assessed retrospectively using the Combined Multimodal Computed Tomography Score (CMCTS), modified to account for the perfusion examination of a limited area. These data were then combined with radiological and clinical outcomes, in particular haemorrhagic stroke transformation and scoring on a modified Rankin scale (mRS). RESULTS: Based on material from 85 patients, the scoring system we employed enabled us to distinguish a group that did not benefit from treatment with specificity and a positive predictive value of 100%, and a negative predictive value of 64%. Neither the relationship between the score and early haemorrhagic complications, nor the effectiveness or severity of the course of the thrombectomy procedure itself was confirmed. CONCLUSIONS: There is no justification for the use of reperfusion procedures in acute ischaemic stroke in the anterior circulation in patients with initially unfavourable multimodal computed tomography scores. Termedia Publishing House 2019-04-29 2019-12 /pmc/articles/PMC6939209/ /pubmed/31908703 http://dx.doi.org/10.5114/wiitm.2019.84761 Text en Copyright: © 2019 Fundacja Videochirurgii http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Łasocha, Bartłomiej
Brzegowy, Paweł
Słowik, Agnieszka
Latacz, Paweł
Pułyk, Roman
Popiela, Tadeusz J.
Outcome estimation based on multimodal computed tomography examination in acute ischaemic stroke patients treated with mechanical thrombectomy
title Outcome estimation based on multimodal computed tomography examination in acute ischaemic stroke patients treated with mechanical thrombectomy
title_full Outcome estimation based on multimodal computed tomography examination in acute ischaemic stroke patients treated with mechanical thrombectomy
title_fullStr Outcome estimation based on multimodal computed tomography examination in acute ischaemic stroke patients treated with mechanical thrombectomy
title_full_unstemmed Outcome estimation based on multimodal computed tomography examination in acute ischaemic stroke patients treated with mechanical thrombectomy
title_short Outcome estimation based on multimodal computed tomography examination in acute ischaemic stroke patients treated with mechanical thrombectomy
title_sort outcome estimation based on multimodal computed tomography examination in acute ischaemic stroke patients treated with mechanical thrombectomy
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939209/
https://www.ncbi.nlm.nih.gov/pubmed/31908703
http://dx.doi.org/10.5114/wiitm.2019.84761
work_keys_str_mv AT łasochabartłomiej outcomeestimationbasedonmultimodalcomputedtomographyexaminationinacuteischaemicstrokepatientstreatedwithmechanicalthrombectomy
AT brzegowypaweł outcomeestimationbasedonmultimodalcomputedtomographyexaminationinacuteischaemicstrokepatientstreatedwithmechanicalthrombectomy
AT słowikagnieszka outcomeestimationbasedonmultimodalcomputedtomographyexaminationinacuteischaemicstrokepatientstreatedwithmechanicalthrombectomy
AT lataczpaweł outcomeestimationbasedonmultimodalcomputedtomographyexaminationinacuteischaemicstrokepatientstreatedwithmechanicalthrombectomy
AT pułykroman outcomeestimationbasedonmultimodalcomputedtomographyexaminationinacuteischaemicstrokepatientstreatedwithmechanicalthrombectomy
AT popielatadeuszj outcomeestimationbasedonmultimodalcomputedtomographyexaminationinacuteischaemicstrokepatientstreatedwithmechanicalthrombectomy