Role of Imaging in Acute Ischemic Stroke

Pavlina, Andrew A.; Radhakrishnan, Rupa; Vagal, Achala

doi:10.1053/j.sult.2018.01.002

Cited by 10 publications

(10 citation statements)

References 55 publications

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“…With the development of radiological technology, neuroimaging plays increasingly important roles in the diagnosis and treatment of central nervous system diseases (15). We previously demonstrated that tiro ban was effective and safe in AIS patients who were not undergoing early recanalization treatments.…”

Section: Discussionmentioning

confidence: 99%

Subtyping treatment response of tirofiban in acute ischemic stroke based on neuroimaging features

Han

Ding

et al. 2023

Preprint

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Our previous trial demonstrated that tirofiban was effective and safe in acute ischemic stroke (AIS) patients who were not undergoing early recanalization treatments. We aimed to further evaluate the structural MRI characteristics and their clinical significance to better predict and guide tirofiban treatment. In this post hoc analysis of imaging features, the location of infarcts (anterior circulation stroke [ACS] vs posterior circulation stroke [PCS]), degree of cerebral artery stenosis (≤ 69% vs ≥ 70% or occlusion), total infarct volume and ASPECTS score were used to predict the treatment response of tirofiban, defined as a proportion of excellent functional outcome (modified Rankin Scale (mRS) score of 0–1) and favorable functional outcome (mRS score of 0–2) at 90 days. Patients with ACS were more likely to achieve excellent functional outcome (p = 0.004) and favorable functional outcome (p = 0.008) when treated with tirofiban. However, there were no significant differences between the two groups for patients with PCS. For patients due to severe stenosis (≥ 70% or occlusion), there were significant differences between the two groups (p = 0.002 for mRS 0–1; p = 0.011 for mRS 0–2). Meanwhile, we found that tirofiban treatment improved clinical outcome only in patients with ASPECTS (8–10) (p = 0.016). In addition, we found that the effect of tirofiban treatment was independent of total infarct volume. The neuroimaging data supported that patients with ACS and severe stenosis were recommended for the application of tirofiban, and better treatment response could be predicted independent of total infarct volume.

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Section: Discussionmentioning

confidence: 99%

Subtyping treatment response of tirofiban in acute ischemic stroke based on neuroimaging features

Han

Ding

et al. 2023

Preprint

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“…At present, the diagnosis of ischemic stroke relies on both clinical assessment (serum biomarkers) and neuroimaging (computed tomography) [22][23][24]. Blood tests can identify multiple biomarkers of ischemic stroke, including proteins involved in inflammation responses, such as C-reactive…”

Section: Diagnosis and Biomarkers Of Ischemic Strokementioning

confidence: 99%

Biological Properties and Clinical Significance of Lipoprotein-Associated Phospholipase A2 in Ischemic Stroke

Zhang

Huang²,

Hu³

et al. 2022

Cardiovascular Therapeutics

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Ischemic stroke, which occurs following blockage of the blood supply to the brain, is a leading cause of death worldwide. Its main cause is atherosclerosis, a disease of the arteries characterized by the deposition of plaques of fatty material on the inner artery walls. Multiple proteins involved in the inflammation response have been identified as diagnosing biomarkers of ischemic stroke. One of these is lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme that can hydrolyze circulating oxidized phospholipids, generating proinflammatory lysophosphatidylcholine and promoting the development of atherosclerosis. In the last two decades, a number of studies have revealed that both the concentration and the activity of Lp-PLA2 are independent biomarkers of ischemic stroke. The US Food and Drug Administration (FDA) has approved two tests to determine Lp-PLA2 mass and activity for predicting stroke. In this review, we summarize the biological properties of Lp-PLA2, the detection sensitivity and limitations of Lp-PLA2 measurement, the clinical significance and association of Lp-PLA2 in ischemic stroke, and the prospects of therapeutic inhibition of Lp-PLA2 as an intervention and treatment.

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“…Selain sebagai alat diagnostik, pemeriksaan radiologi berperan, serta digunakan sebagai dasar tatalaksana. 6 Pemeriksaan radiologi merupakan pemeriksaan terbaik untuk membedakan stroke iskemik dan hemoragik, juga salah satu faktor penentu kontraindikasi tindakan trombolisis intravena serta menjadi salah satu kriteria tindakan trombektomi mekanik. 2,7 Pemeriksaan MRI dengan DWI memiliki sensitivitas yang lebih baik dan dapat mendeteksi kasus stroke iskemik akut lebih dini dibandingkan CT Scan non-kontras.…”

Section: Pencitraan Pada Stroke Iskemikunclassified

Sistem Skoring Alberta Stroke Program Early CT Score untuk Evaluasi Kasus Stroke Iskemik

Michael

2020

CDK

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<p>Sistem skoring Alberta Stroke Program Early CT Score (ASPECTS) merupakan alat skoring semi – kuantitatif sederhana untuk mengevaluasi gambaran iskemi akut pada CT scan non kontras atau MRI. Pada awal publikasinya, sistem skoring ini dianggap dapat memprediksi outcome fungsional dan kejadian transformasi perdarahan pada pasien yang menjalani trombolisis intravena dengan alteplase. Namun rekomendasi terbaru tidak lagi merekomendasikannya. Data efektivitas trombektomi mekanik pada populasi dengan nilai ASPECTS ≤ 5 belum cukup. Tulisan ini membahas cara menilai, kegunaan serta implikasi sistem skoring ASPECTS terhadap tatalaksana pasien dengan stroke iskemi akut</p><p>Alberta Stroke Program Early CT Score (ASPECTS) is a simple semi-quantitative scoring system to evaluate the noncontrast CT Scan or MRI imaging of acute ischemic lesion. Originally, the scoring system was considered able to predict the functional outcome and hemorrhagic transformation in patient undergoing intravenous thrombolysis with alteplase. However, the latest guideline does not recommend ASPECTS to determine the eligibility of patient undergoing alteplase therapy. Data regarding the efficacy of MT in patient with ASPECTS ≤ 5 is scarce and is still a subject of debate. This article will discuss the evaluation and the implication of ASPECTS scoring system in the management of acute ischemic stroke.</p>

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Role of Imaging in Acute Ischemic Stroke

Cited by 10 publications

References 55 publications

Subtyping treatment response of tirofiban in acute ischemic stroke based on neuroimaging features

Subtyping treatment response of tirofiban in acute ischemic stroke based on neuroimaging features

Biological Properties and Clinical Significance of Lipoprotein-Associated Phospholipase A2 in Ischemic Stroke

Sistem Skoring Alberta Stroke Program Early CT Score untuk Evaluasi Kasus Stroke Iskemik

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