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Long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease
This study aimed to demonstrate the effectiveness of nonemergent extracranial-to-intracranial bypass (EIB) in symptomatic chronic large artery atherosclerotic stenosis or occlusive disease (LAA) through quantitative analysis of computed tomography perfusion (CTP) parameters using RAPID software. We...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9988922/ https://www.ncbi.nlm.nih.gov/pubmed/36879127 http://dx.doi.org/10.1038/s41598-023-30874-8 |
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author | Jo, Hyunjun Lee, Si Un Jeong, Han-Gil Kim, Young-Deok Kim, Tackeun Sunwoo, Leonard Ban, Seung Pil Bang, Jae Seung Kwon, Oki Oh, Chang Wan |
author_facet | Jo, Hyunjun Lee, Si Un Jeong, Han-Gil Kim, Young-Deok Kim, Tackeun Sunwoo, Leonard Ban, Seung Pil Bang, Jae Seung Kwon, Oki Oh, Chang Wan |
author_sort | Jo, Hyunjun |
collection | PubMed |
description | This study aimed to demonstrate the effectiveness of nonemergent extracranial-to-intracranial bypass (EIB) in symptomatic chronic large artery atherosclerotic stenosis or occlusive disease (LAA) through quantitative analysis of computed tomography perfusion (CTP) parameters using RAPID software. We retrospectively analyzed 86 patients who underwent nonemergent EIB due to symptomatic chronic LAA. CTP data obtained preoperatively, immediately postoperatively (PostOp0), and 6 months postoperatively (PostOp6M) after EIB were quantitatively analyzed through RAPID software, and their association with intraoperative bypass flow (BF) was assessed. The clinical outcomes, including neurologic state, incidence of recurrent infarction and complications, were also analyzed. The time-to-maximum (Tmax) > 8 s, > 6 s and > 4 s volumes decreased significantly at PostOp0 and up through PostOp6M (preoperative, 5, 51, and 223 ml (median), respectively; PostOp0, 0, 20.25, and 143 ml, respectively; PostOp6M, 0, 7.5, and 148.5 ml, respectively; p < 0.001, p < 0.001, and p < 0.001, respectively). The postoperative improvement in the Tmax > 6 s and > 4 s volumes was significantly correlated with the BF at PostOp0 and PostOp6M (PostOp0, r = 0.367 (p = 0.001) and r = 0.275 (p = 0.015), respectively; PostOp6M r = 0.511 (p < 0.001) and r = 0.391 (p = 0.001), respectively). The incidence of recurrent cerebral infarction was 4.7%, and there were no major complications that produced permanent neurological impairment. Nonemergent EIB under strict operation indications can be a feasible treatment for symptomatic, hemodynamically compromised LAA patients. |
format | Online Article Text |
id | pubmed-9988922 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-99889222023-03-08 Long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease Jo, Hyunjun Lee, Si Un Jeong, Han-Gil Kim, Young-Deok Kim, Tackeun Sunwoo, Leonard Ban, Seung Pil Bang, Jae Seung Kwon, Oki Oh, Chang Wan Sci Rep Article This study aimed to demonstrate the effectiveness of nonemergent extracranial-to-intracranial bypass (EIB) in symptomatic chronic large artery atherosclerotic stenosis or occlusive disease (LAA) through quantitative analysis of computed tomography perfusion (CTP) parameters using RAPID software. We retrospectively analyzed 86 patients who underwent nonemergent EIB due to symptomatic chronic LAA. CTP data obtained preoperatively, immediately postoperatively (PostOp0), and 6 months postoperatively (PostOp6M) after EIB were quantitatively analyzed through RAPID software, and their association with intraoperative bypass flow (BF) was assessed. The clinical outcomes, including neurologic state, incidence of recurrent infarction and complications, were also analyzed. The time-to-maximum (Tmax) > 8 s, > 6 s and > 4 s volumes decreased significantly at PostOp0 and up through PostOp6M (preoperative, 5, 51, and 223 ml (median), respectively; PostOp0, 0, 20.25, and 143 ml, respectively; PostOp6M, 0, 7.5, and 148.5 ml, respectively; p < 0.001, p < 0.001, and p < 0.001, respectively). The postoperative improvement in the Tmax > 6 s and > 4 s volumes was significantly correlated with the BF at PostOp0 and PostOp6M (PostOp0, r = 0.367 (p = 0.001) and r = 0.275 (p = 0.015), respectively; PostOp6M r = 0.511 (p < 0.001) and r = 0.391 (p = 0.001), respectively). The incidence of recurrent cerebral infarction was 4.7%, and there were no major complications that produced permanent neurological impairment. Nonemergent EIB under strict operation indications can be a feasible treatment for symptomatic, hemodynamically compromised LAA patients. Nature Publishing Group UK 2023-03-06 /pmc/articles/PMC9988922/ /pubmed/36879127 http://dx.doi.org/10.1038/s41598-023-30874-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Jo, Hyunjun Lee, Si Un Jeong, Han-Gil Kim, Young-Deok Kim, Tackeun Sunwoo, Leonard Ban, Seung Pil Bang, Jae Seung Kwon, Oki Oh, Chang Wan Long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease |
title | Long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease |
title_full | Long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease |
title_fullStr | Long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease |
title_full_unstemmed | Long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease |
title_short | Long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease |
title_sort | long-term outcomes and quantitative radiologic analysis of extracranial–intracranial bypass for hemodynamically compromised chronic large artery occlusive disease |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9988922/ https://www.ncbi.nlm.nih.gov/pubmed/36879127 http://dx.doi.org/10.1038/s41598-023-30874-8 |
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