Venous Outflow Profiles Are Linked to Cerebral Edema Formation at Noncontrast Head CT after Treatment in Acute Ischemic Stroke Regardless of Collateral Vessel Status at CT Angiography

Faizy, Tobias D.; Kabiri, Reza; Christensen, Søren; Mlynash, Michael; Kuraitis, Gabriella; Meyer, Lukas; Marks, Michael P.; Broocks, Gabriel; Flottmann, Fabian; Lansberg, Maarten G; Albers, Gregory W.; Fiehler, Jens; Wintermark, Max; Heit, Jeremy J

doi:10.1148/radiol.2021203651

Cited by 57 publications

(75 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results supported the hypothesis that in the case of sufficient arterial inflow after excellent vessel recanalization, obstacle of VO due to venous micro-emboli and the destruction of microcirculation involved in exacerbation of brain oedema and haemorrhage transformation delayed the peak of vein opacification. 24 Further studies should be conducted to confirm the results. Of note, PTV, baseline NIHSS and ASPECTS had the same predictive effect on FR.…”

Section: Discussionmentioning

confidence: 92%

“…Favourable cortical vein opacification contributed to good clinical outcome after endovascular treatment and vice versa regardless of arterial collaterals. 24 Poor VO results in microthrombi formation and occlusion in venules and exacerbates brain oedema. 8 These studies selected cortical veins as target veins for qualitative assessment, which may introduce bias due to vein variation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Venous Flow Profiles on Perfusion CT are Associated with Futile Recanalization After Thrombectomy

Su¹,

Chen²,

Chen³

et al. 2022

NDT

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Venous Flow Profiles on Perfusion CT are Associated with Futile Recanalization After Thrombectomy

Su¹,

Chen²,

Chen³

et al. 2022

NDT

View full text Add to dashboard Cite

“…A previous study showed an association between favorable venous flow profiles and ischemic lesion NWU growth ( 28 ). Favorable tissue-level collaterals were also reported predicting less ischemic lesion NWU after performing thrombectomy in patients with large vessel occlusion ( 29 ). We did not find a statistically significant relation between modified ASITN/SIR score on dynamic CT and NWU, but there was the tendency of different NWU between good collateral and poor collateral groups.…”

Section: Discussionmentioning

confidence: 98%

Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients

et al. 2022

View full text Add to dashboard Cite

ObjectiveTo investigate the difference in early edema, quantified by net water uptake (NWU) based on computed tomography (CT) between ischemic core and penumbra and to explore predictors of NWU and test its predictive power for clinical outcome.MethodsRetrospective analysis was conducted on patients admitted to Ningbo First Hospital with anterior circulation stroke and multi-modal CT. In 154 included patients, NWU of the ischemic core and penumbra were calculated and compared by Mann–Whitney U test. Correlations between NWU and variables including age, infarct time (time from symptom onset to imaging), volume of ischemic core, collateral status, and National Institutes of Health Stroke Scale (NIHSS) scores were investigated by Spearman's correlation analyses. Clinical outcome was defined using the modified Rankin Scale (mRS) at 90 days. Logistic regression and receiver operating characteristic analyses were performed to test the predictive value of NWU. Summary statistics are presented as median (interquartile range), mean (standard deviation) or estimates (95% confidence interval).ResultsThe NWU within the ischemic core [6.1% (2.9–9.2%)] was significantly higher than that of the penumbra [1.8% (−0.8–4.0%)]. The only significant predictor of NWU within the ischemic core was infarct time (p = 0.004). The NWU within the ischemic core [odds ratio = 1.23 (1.10–1.39)], the volume of ischemic core [1.04, (1.02–1.06)], age [1.09 (1.01–1.17)], and admission NHISS score [1.05 (1.01–1.09)] were associated with the outcome of patients adjusted for sex and treatment. The predictive power for the outcome of the model was significantly higher when NWU was included (area under the curve 0.875 vs. 0.813, p < 0.05 by Delong test).ConclusionsEarly edema quantified by NWU is relatively limited in the ischemic core and develops in a time-dependent manner. NWU estimates within the ischemic core may help to predict clinical outcomes of patients with acute ischemic stroke.

show abstract

“…e-CTA provides real-time collateral scoring with the potential to improve consistency of image interpretation and to quantify collateral scores independently (Figure 3). Recently, venous outflow profiles have been investigated in the setting of LVO stroke and were associated with reduced edema formation and good functional outcomes [63].…”

Section: Collateral Scorementioning

confidence: 99%

“…Recently, venous outflow profiles have been investigated in the setting of LVO stroke and were associated with reduced edema formation and good functional outcomes [63].…”

Section: Perfusion Mapsmentioning

confidence: 99%

How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods

Zeleňák

Krajina

Meyer

et al. 2021

Life

Self Cite

View full text Add to dashboard Cite

Stroke remains one of the leading causes of death and disability in Europe. The European Stroke Action Plan (ESAP) defines four main targets for the years 2018 to 2030. The COVID-19 pandemic forced the use of innovative technologies and created pressure to improve internet networks. Moreover, 5G internet network will be helpful for the transfer and collecting of extremely big databases. Nowadays, the speed of internet connection is a limiting factor for robotic systems, which can be controlled and commanded potentially from various places in the world. Innovative technologies can be implemented for acute stroke patient management soon. Artificial intelligence (AI) and robotics are used increasingly often without the exception of medicine. Their implementation can be achieved in every level of stroke care. In this article, all steps of stroke health care processes are discussed in terms of how to improve them (including prehospital diagnosis, consultation, transfer of the patient, diagnosis, techniques of the treatment as well as rehabilitation and usage of AI). New ethical problems have also been discovered. Everything must be aligned to the concept of “time is brain”.

show abstract

Venous Outflow Profiles Are Linked to Cerebral Edema Formation at Noncontrast Head CT after Treatment in Acute Ischemic Stroke Regardless of Collateral Vessel Status at CT Angiography

Cited by 57 publications

References 30 publications

Venous Flow Profiles on Perfusion CT are Associated with Futile Recanalization After Thrombectomy

Venous Flow Profiles on Perfusion CT are Associated with Futile Recanalization After Thrombectomy

Early Edema Within the Ischemic Core Is Time-Dependent and Associated With Functional Outcomes of Acute Ischemic Stroke Patients

How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods

Contact Info

Product

Resources

About