Cerebral Small Vessel Disease and Infarct Growth in Acute Ischemic Stroke Treated with Intravenous Thrombolysis

被引：3

作者：

Arba, Francesco ^{[1
]}

Ferretti, Simone ^{[2
]}

Leigh, Richard ^{[3
]}

Fara, Andreia ^{[3
]}

Warach, Steven J. ^{[4
]}

Luby, Marie ^{[3
]}

Lees, Kennedy R. ^{[5
]}

Dawson, Jesse ^{[5
]}

机构：

[1] Careggi Univ Hosp, Stroke Unit, Florence, Italy

[2] Univ Florence, Careggi Univ Hosp, NEUROFARBA Dept, Florence, Italy

[3] NINDS, NIH, Bethesda, MD USA

[4] Univ Texas Austin, Dept Neurol, Dell Med Sch, Austin, TX USA

[5] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Scotland

来源：

TRANSLATIONAL STROKE RESEARCH | 2025年 / 16卷 / 03期

关键词：

Ischemic stroke; Thrombolysis; rt-PA; Small vessel disease; White matter changes; Lacunar infarct; WHITE-MATTER LESIONS; CLINICAL-OUTCOMES; TRIAL IST-3; LEUKOARAIOSIS;

D O I：

10.1007/s12975-024-01277-2

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

We investigated relations between cerebral small vessel disease (cSVD) markers and evolution of the ischemic tissue from ischemic core to final infarct in people with acute ischemic stroke treated with intravenous thrombolysis. Data from the Stroke Imaging Repository (STIR) and Virtual International Stroke Trials Archive (VISTA) were used. Any pre-existing lacunar infarcts and white matter hyperintensities (WMH) were assessed on magnetic resonance (MR) before thrombolytic therapy. Acute ischemic core and final infarct volume were then assessed by two independent radiologists. The relationship among baseline markers of cSVD, acute ischemic core volume, final infarct volume, infarct growth (IG = final infarct - ischemic core), and infarct growth ratio (IGR = final infarct/ischemic core) was then assessed using linear and ordinal regression adjusted for age, sex, onset-to-treatment time, and stroke severity. We included 165 patients, mean (+/- SD) age 69.5 (+/- 15.7) years, 74 (45%) males, mean (+/- SD) ischemic core volume 25.48 (+/- 42.22) ml, final infarct volume 52.06 (+/- 72.88) ml, IG 26.58 (+/- 51.02) ml, IGR 8.23 (+/- 38.12). Seventy (42%) patients had large vessel occlusion, 20 (12%) acute small subcortical infarct. WMHs were present in 131 (79%) and lacunar infarcts in 61 (37%) patients. Final infarct volumes were 53.8 ml and 45.2 ml (WMHs/no WMHs), p = 0.139, and 24.6 ml and 25.9 ml (lacunar infarcts/no lacunar infarcts), p = 0.842. In linear and ordinal regression analyses, presence of lacunar infarcts was associated with smaller IG (beta = - 0.17; p = 0.024; cOR = 0.52; 95%CI = 0.28-0.96, respectively) and WMHs were associated with smaller IGR (beta = - 0.30; p = 0.004; cOR = 0.27; 95%CI = 0.11-0.69, respectively). In people with acute ischemic stroke treated with intravenous thrombolysis, cSVD features were associated with smaller growth of the acute ischemic area, suggesting less salvageable tissue at time of reperfusion therapy.

引用

页码：925 / 932

页数：8

共 22 条

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