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Early Venous Filling Following Thrombectomy: Association With Hemorrhagic Transformation and Functional Outcome
Background and Purpose: Previous studies have noted the angiographic appearance of early venous filling (EVF) following recanalisation in acute ischemic stroke. However, the prognostic implications of EVF as a novel imaging biomarker remain unclear. We aimed to evaluate the correlation between EVF w...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987949/ https://www.ncbi.nlm.nih.gov/pubmed/33776899 http://dx.doi.org/10.3389/fneur.2021.649079 |
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author | Elands, Sophie Casimir, Pierre Bonnet, Thomas Mine, Benjamin Lubicz, Boris Sjøgård, Martin Ligot, Noémie Naeije, Gilles |
author_facet | Elands, Sophie Casimir, Pierre Bonnet, Thomas Mine, Benjamin Lubicz, Boris Sjøgård, Martin Ligot, Noémie Naeije, Gilles |
author_sort | Elands, Sophie |
collection | PubMed |
description | Background and Purpose: Previous studies have noted the angiographic appearance of early venous filling (EVF) following recanalisation in acute ischemic stroke. However, the prognostic implications of EVF as a novel imaging biomarker remain unclear. We aimed to evaluate the correlation between EVF with (i) the risk of subsequent reperfusion hemorrhage (RPH) and (ii) the association of EVF on both the NIHSS score at 24 h and functional outcome as assessed with the Modified Rankin Scale (mRS) score at 90 days. Methods: We conducted a retrospective cohort study of patients presenting with an acute ischemic stroke due to a proximal large-vessel occlusion of the anterior circulation treated by thrombectomy. Post-reperfusion digital subtraction angiography was reviewed to look for EVF as evidenced by the contrast opacification of any cerebral vein before the late arterial phase. Results: EVF occurred in 22.4% of the 147 cases included. The presence of EVF significantly increased the risk of RPH (p = 0.0048), including the risk of symptomatic hemorrhage (p = 0.0052). The presence of EVF (p = 0.0016) and the absence of RPH (p = 0.0021) were independently associated with a better outcome as defined by the NIHSS difference at 24 h, most significantly in the EVF(+)RPH(−) group. No significant relationship was however found between either EVF or RPH and a mRS score ≤ 2 at 90 days. Conclusion: Early venous filling on angiographic imaging is a potential predictor of reperfusion hemorrhage. The absence of subsequent RPH in this sub-group is associated with better outcomes at 24 h post-thrombectomy than in those with RPH. |
format | Online Article Text |
id | pubmed-7987949 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79879492021-03-25 Early Venous Filling Following Thrombectomy: Association With Hemorrhagic Transformation and Functional Outcome Elands, Sophie Casimir, Pierre Bonnet, Thomas Mine, Benjamin Lubicz, Boris Sjøgård, Martin Ligot, Noémie Naeije, Gilles Front Neurol Neurology Background and Purpose: Previous studies have noted the angiographic appearance of early venous filling (EVF) following recanalisation in acute ischemic stroke. However, the prognostic implications of EVF as a novel imaging biomarker remain unclear. We aimed to evaluate the correlation between EVF with (i) the risk of subsequent reperfusion hemorrhage (RPH) and (ii) the association of EVF on both the NIHSS score at 24 h and functional outcome as assessed with the Modified Rankin Scale (mRS) score at 90 days. Methods: We conducted a retrospective cohort study of patients presenting with an acute ischemic stroke due to a proximal large-vessel occlusion of the anterior circulation treated by thrombectomy. Post-reperfusion digital subtraction angiography was reviewed to look for EVF as evidenced by the contrast opacification of any cerebral vein before the late arterial phase. Results: EVF occurred in 22.4% of the 147 cases included. The presence of EVF significantly increased the risk of RPH (p = 0.0048), including the risk of symptomatic hemorrhage (p = 0.0052). The presence of EVF (p = 0.0016) and the absence of RPH (p = 0.0021) were independently associated with a better outcome as defined by the NIHSS difference at 24 h, most significantly in the EVF(+)RPH(−) group. No significant relationship was however found between either EVF or RPH and a mRS score ≤ 2 at 90 days. Conclusion: Early venous filling on angiographic imaging is a potential predictor of reperfusion hemorrhage. The absence of subsequent RPH in this sub-group is associated with better outcomes at 24 h post-thrombectomy than in those with RPH. Frontiers Media S.A. 2021-03-10 /pmc/articles/PMC7987949/ /pubmed/33776899 http://dx.doi.org/10.3389/fneur.2021.649079 Text en Copyright © 2021 Elands, Casimir, Bonnet, Mine, Lubicz, Sjøgård, Ligot and Naeije. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Elands, Sophie Casimir, Pierre Bonnet, Thomas Mine, Benjamin Lubicz, Boris Sjøgård, Martin Ligot, Noémie Naeije, Gilles Early Venous Filling Following Thrombectomy: Association With Hemorrhagic Transformation and Functional Outcome |
title | Early Venous Filling Following Thrombectomy: Association With Hemorrhagic Transformation and Functional Outcome |
title_full | Early Venous Filling Following Thrombectomy: Association With Hemorrhagic Transformation and Functional Outcome |
title_fullStr | Early Venous Filling Following Thrombectomy: Association With Hemorrhagic Transformation and Functional Outcome |
title_full_unstemmed | Early Venous Filling Following Thrombectomy: Association With Hemorrhagic Transformation and Functional Outcome |
title_short | Early Venous Filling Following Thrombectomy: Association With Hemorrhagic Transformation and Functional Outcome |
title_sort | early venous filling following thrombectomy: association with hemorrhagic transformation and functional outcome |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987949/ https://www.ncbi.nlm.nih.gov/pubmed/33776899 http://dx.doi.org/10.3389/fneur.2021.649079 |
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