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Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective

Advanced neuroimaging is one of the most important means that we have in the attempt to overcome time constraints and expand the use of intravenous thrombolysis (IVT). We assessed whether, and how, the prior use of advanced neuroimaging (AN), and more specifically CT/MR perfusion post-processed with...

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Autores principales: Psychogios, Klearchos, Safouris, Apostolos, Kargiotis, Odysseas, Magoufis, Georgios, Andrikopoulou, Athina, Papageorgiou, Ermioni, Chondrogianni, Maria, Papadimitropoulos, Georgios, Polyzogopoulou, Eftihia, Spiliopoulos, Stavros, Brountzos, Elias, Stamboulis, Elefterios, Giannopoulos, Sotirios, Tsivgoulis, Georgios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268827/
https://www.ncbi.nlm.nih.gov/pubmed/34206790
http://dx.doi.org/10.3390/jcm10132819
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author Psychogios, Klearchos
Safouris, Apostolos
Kargiotis, Odysseas
Magoufis, Georgios
Andrikopoulou, Athina
Papageorgiou, Ermioni
Chondrogianni, Maria
Papadimitropoulos, Georgios
Polyzogopoulou, Eftihia
Spiliopoulos, Stavros
Brountzos, Elias
Stamboulis, Elefterios
Giannopoulos, Sotirios
Tsivgoulis, Georgios
author_facet Psychogios, Klearchos
Safouris, Apostolos
Kargiotis, Odysseas
Magoufis, Georgios
Andrikopoulou, Athina
Papageorgiou, Ermioni
Chondrogianni, Maria
Papadimitropoulos, Georgios
Polyzogopoulou, Eftihia
Spiliopoulos, Stavros
Brountzos, Elias
Stamboulis, Elefterios
Giannopoulos, Sotirios
Tsivgoulis, Georgios
author_sort Psychogios, Klearchos
collection PubMed
description Advanced neuroimaging is one of the most important means that we have in the attempt to overcome time constraints and expand the use of intravenous thrombolysis (IVT). We assessed whether, and how, the prior use of advanced neuroimaging (AN), and more specifically CT/MR perfusion post-processed with RAPID software, regardless of time from symptoms onset, affected the outcomes of acute ischemic stroke (AIS) patients who received IVT. Methods. We retrospectively evaluated consecutive AIS patients who received intravenous thrombolysis monotherapy (without endovascular reperfusion) during a six-year period. The study population was divided into two groups according to the neuroimaging protocol used prior to IVT administration in AIS patients (AN+ vs. AN−). Safety outcomes included any intracranial hemorrhage (ICH) and 3-month mortality. Effectiveness outcomes included door-to-needle time, neurological status (NIHSS-score) on discharge, and functional status at three months assessed by the modified Rankin Scale (mRS). Results. The rate of IVT monotherapy increased from ten patients per year (n = 29) in the AN− to fifteen patients per year (n = 47) in the AN+ group. Although the onset-to-treatment time was longer in the AN+ cohort, the two groups did not differ in door-to-needle time, discharge NIHSS-score, symptomatic ICH, any ICH, 3-month favorable functional outcome (mRS-scores of 0–1), 3-month functional independence (mRS-scores of 0–2), distribution of 3-month mRS-scores, or 3-month mortality. Conclusion. Our pilot observational study showed that the incorporation of advanced neuroimaging in the acute stroke chain pathway in AIS patients increases the yield of IVT administration without affecting the effectiveness and safety of the treatment.
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spelling pubmed-82688272021-07-10 Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective Psychogios, Klearchos Safouris, Apostolos Kargiotis, Odysseas Magoufis, Georgios Andrikopoulou, Athina Papageorgiou, Ermioni Chondrogianni, Maria Papadimitropoulos, Georgios Polyzogopoulou, Eftihia Spiliopoulos, Stavros Brountzos, Elias Stamboulis, Elefterios Giannopoulos, Sotirios Tsivgoulis, Georgios J Clin Med Article Advanced neuroimaging is one of the most important means that we have in the attempt to overcome time constraints and expand the use of intravenous thrombolysis (IVT). We assessed whether, and how, the prior use of advanced neuroimaging (AN), and more specifically CT/MR perfusion post-processed with RAPID software, regardless of time from symptoms onset, affected the outcomes of acute ischemic stroke (AIS) patients who received IVT. Methods. We retrospectively evaluated consecutive AIS patients who received intravenous thrombolysis monotherapy (without endovascular reperfusion) during a six-year period. The study population was divided into two groups according to the neuroimaging protocol used prior to IVT administration in AIS patients (AN+ vs. AN−). Safety outcomes included any intracranial hemorrhage (ICH) and 3-month mortality. Effectiveness outcomes included door-to-needle time, neurological status (NIHSS-score) on discharge, and functional status at three months assessed by the modified Rankin Scale (mRS). Results. The rate of IVT monotherapy increased from ten patients per year (n = 29) in the AN− to fifteen patients per year (n = 47) in the AN+ group. Although the onset-to-treatment time was longer in the AN+ cohort, the two groups did not differ in door-to-needle time, discharge NIHSS-score, symptomatic ICH, any ICH, 3-month favorable functional outcome (mRS-scores of 0–1), 3-month functional independence (mRS-scores of 0–2), distribution of 3-month mRS-scores, or 3-month mortality. Conclusion. Our pilot observational study showed that the incorporation of advanced neuroimaging in the acute stroke chain pathway in AIS patients increases the yield of IVT administration without affecting the effectiveness and safety of the treatment. MDPI 2021-06-26 /pmc/articles/PMC8268827/ /pubmed/34206790 http://dx.doi.org/10.3390/jcm10132819 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Psychogios, Klearchos
Safouris, Apostolos
Kargiotis, Odysseas
Magoufis, Georgios
Andrikopoulou, Athina
Papageorgiou, Ermioni
Chondrogianni, Maria
Papadimitropoulos, Georgios
Polyzogopoulou, Eftihia
Spiliopoulos, Stavros
Brountzos, Elias
Stamboulis, Elefterios
Giannopoulos, Sotirios
Tsivgoulis, Georgios
Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective
title Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective
title_full Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective
title_fullStr Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective
title_full_unstemmed Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective
title_short Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective
title_sort advanced neuroimaging preceding intravenous thrombolysis in acute ischemic stroke patients is safe and effective
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268827/
https://www.ncbi.nlm.nih.gov/pubmed/34206790
http://dx.doi.org/10.3390/jcm10132819
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