Thromboelastography as a predictor of functional outcome in acute ischemic stroke patients undergoing endovascular treatment

被引：6

作者：

Ryu, Jae-Chan ^{[1
]}

Jung, Seunguk ^{[2
]}

Bae, Jae-Han ^{[1
]}

Ha, Sang Hee ^{[1
]}

Kim, Bum Joon ^{[1
]}

Jeon, Sang-Beom ^{[1
]}

Kang, Dong-Wha ^{[1
]}

Kwon, Sun U. ^{[1
]}

Kim, Jong S. ^{[3
]}

Chang, Jun Young ^{[1
]}

机构：

[1] Univ Ulsan, Asan Med Ctr, Dept Neurol, Coll Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea

[2] Gyeongsang Natl Univ, Dept Neurol, Changwon Hosp, Chang Won, South Korea

[3] Univ Ulsan, Gangneung Asan Hosp, Dept Neurol, Coll Med, Kangnung, South Korea

来源：

THROMBOSIS RESEARCH | 2023年 / 225卷

关键词：

Thromboelastography; Reaction time; Endovascular treatment; Hypercoagulability; Ischemic stroke; EARLY NEUROLOGICAL DETERIORATION; HEMORRHAGIC TRANSFORMATION; THROMBECTOMY; AGE;

D O I：

10.1016/j.thromres.2023.03.015

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Thromboelastography (TEG) is a useful for predicting hemorrhagic transformation, early neuro-logical deterioration, and functional outcome after stroke. We aimed to investigate whether TEG value could also be useful in predicting functional outcome via various intraprocedural and postprocedural factors in patients with acute large vessel occlusive stroke who underwent intraarterial thrombectomy (IAT).Methods: Patients with ischemic stroke who underwent IAT between March 2018 and March 2020 at two tertiary hospitals were included. The association between reaction time (R) and functional outcome was evaluated. The primary outcome was the achievement of functional independence defined as the achievement of a modified Rankin Scale (mRS) score of 0-2 at 3 months after the index stroke. Results: Among a total of 160 patients (mean age, 70.6 +/- 12.3 years; 103 [64.4 %] men), 79 (49.3 %) achieved functional independence at 3 months. R, both as a continuous (odds ratio [OR]: 1.45, 95 % confidence interval [95 % CI]: 1.09-1.92, P = 0.011) and dichotomized parameters (R < 5 min [OR: 0.37, 95 % CI: 0.16-0.82, P = 0.014]), were inversely associated with increased odds of achieving functional independence (mRS score 0-2) after multivariable analysis. The association was still consistent when the outcome was the achievement of disability free (mRS score 0-1) or mRS score analyzed as an ordinal variable.Conclusions: Decreased R, especially R < 5 min, was inversely associated with functional outcome pf stroke after EVT.

引用

页码：95 / 100

页数：6

共 32 条

[1] Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging [J].

Albers, G. W. ;

Marks, M. P. ;

Kemp, S. ;

Christensen, S. ;

Tsai, J. P. ;

Ortega-Gutierrez, S. ;

McTaggart, R. A. ;

Torbey, M. T. ;

Kim-Tenser, M. ;

Leslie-Mazwi, T. ;

Sarraj, A. ;

Kasner, S. E. ;

Ansari, S. A. ;

Yeatts, S. D. ;

Hamilton, S. ;

Mlynash, M. ;

Heit, J. J. ;

Zaharchuk, G. ;

Kim, S. ;

Carrozzella, J. ;

Palesch, Y. Y. ;

Demchuk, A. M. ;

Bammer, R. ;

Lavori, P. W. ;

Broderick, J. P. ;

Lansberg, M. G. .

NEW ENGLAND JOURNAL OF MEDICINE, 2018, 378 (08) :708-718

[2] Impact of Age and Baseline NIHSS Scores on Clinical Outcomes in the Mechanical Thrombectomy Using Solitaire FR in Acute Ischemic Stroke Study [J].

Almekhlafi, M. A. ;

Davalos, A. ;

Bonafe, A. ;

Chapot, R. ;

Gralla, J. ;

Pereira, V. M. ;

Goyal, M. .

AMERICAN JOURNAL OF NEURORADIOLOGY, 2014, 35 (07) :1337-1340

[3] A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke [J].

Berkhemer, O. A. ;

Fransen, P. S. S. ;

Beumer, D. ;

van den Berg, L. A. ;

Lingsma, H. F. ;

Yoo, A. J. ;

Schonewille, W. J. ;

Vos, J. A. ;

Nederkoorn, P. J. ;

Wermer, M. J. H. ;

van Walderveen, M. A. A. ;

Staals, J. ;

Hofmeijer, J. ;

van Oostayen, J. A. ;

Nijeholt, G. J. Lycklama A. ;

Boiten, J. ;

Brouwer, P. A. ;

Emmer, B. J. ;

de Bruijn, S. F. ;

van Dijk, L. C. ;

Kappelle, L. J. ;

Lo, R. H. ;

Van Dijk, E. J. ;

de Vries, J. ;

de Kort, P. L. M. ;

van Rooij, W. J. J. ;

van den Berg, J. S. P. ;

van Hasselt, B. A. A. M. ;

Aerden, L. A. M. ;

Dallinga, R. J. ;

Visser, M. C. ;

Bot, J. C. J. ;

Vroomen, P. C. ;

Eshghi, O. ;

Schreuder, T. H. C. M. L. ;

Heijboer, R. J. J. ;

Keizer, K. ;

Tielbeek, A. V. ;

den Hertog, H. M. ;

Gerrits, D. G. ;

van den Berg-Vos, R. M. ;

Karas, G. B. ;

Steyerberg, E. W. ;

Flach, H. Z. ;

Marquering, H. A. ;

Sprengers, M. E. S. ;

Jenniskens, S. F. M. ;

Beenen, L. F. M. ;

van den Berg, R. ;

Koudstaal, P. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (01) :11-20

[4] Thromboelastography and rotational thromboelastometry for the surgical intensivist: A narrative review [J].

Drumheller, Byron C. ;

Stein, Deborah M. ;

Moore, Laura J. ;

Rizoli, Sandro B. ;

Cohen, Mitchell J. .

JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, 2019, 86 (04) :710-721

[5] CTA collateral score predicts infarct volume and clinical outcome after endovascular therapy for acute ischemic stroke: a retrospective chart review [J].

Elijovich, Lucas ;

Goya, Nitin ;

Mainali, Shraddha ;

Hoit, Dan ;

Arthur, Adam S. ;

Whitehead, Matthew ;

Choudhri, Asim F. .

JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2016, 8 (06) :559-562

[6] Thromboelastography in patients with acute ischemic stroke [J].

Elliott, Andrea ;

Wetzel, Jeremy ;

Roper, Tiffany ;

Pivalizza, Evan ;

McCarthy, James ;

Wallace, Cristina ;

Hess, Mary Jane ;

Peng, Hui ;

Rahbar, Mohammad H. ;

Sangha, Navdeep ;

Grotta, James C. .

INTERNATIONAL JOURNAL OF STROKE, 2015, 10 (02) :194-201

[7] THROMBOELASTOGRAPHIC STUDIES IN CEREBRAL INFARCTION [J].

ETTINGER, MG .

STROKE, 1974, 5 (03) :350-354

[8] Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials [J].

Goyal, Mayank ;

Menon, Bijoy K. ;

van Zwam, Wim H. ;

Dippel, Diederik W. J. ;

Mitchell, Peter J. ;

Demchuk, Andrew M. ;

Davalos, Antoni ;

Majoie, Charles B. L. M. ;

van der Lugt, Aad ;

de Miquel, Maria A. ;

Donnan, Geoff Rey A. ;

Roos, Yvo B. W. E. M. ;

Bonafe, Alain ;

Jahan, Reza ;

Diener, Hans-Christoph ;

van den Berg, Lucie A. ;

Levy, Elad I. ;

Berkhemer, Olvert A. ;

Pereira, Vitor M. ;

Rempel, Jeremy ;

Millan, Monica ;

Davis, Stephen M. ;

Roy, Daniel ;

Thornton, John ;

San Roman, Luis ;

Ribo, Marc ;

Beumer, Debbie ;

Stouch, Bruce ;

Brown, Scott ;

Campbell, Bruce C. V. ;

van Oostenbrugge, Robert J. ;

Saver, Jeff Rey L. ;

Hill, Michael D. ;

Jovin, Tudor G. .

LANCET, 2016, 387 (10029) :1723-1731

[9] Collateral Circulation and Outcome in Atherosclerotic Versus Cardioembolic Cerebral Large Vessel Occlusion [J].

Guglielmi, Valeria ;

LeCouffe, Natalie E. ;

Zinkstok, Sanne M. ;

Compagne, Kars C. J. ;

Eker, Reyhan ;

Treurniet, Kilian M. ;

Tolhuisen, Manon L. ;

van der Worp, H. Bart ;

Jansen, Ivo G. H. ;

van Oostenbrugge, Robert J. ;

Marquering, Henk A. ;

Dippel, Diederik W. J. ;

Emmer, Bart J. ;

Majoie, Charles B. L. M. ;

Roos, Yvo B. W. E. M. ;

Coutinho, Jonathan M. ;

van der Lugt, Aad ;

van Zwam, Wim H. ;

Boiten, Jelis ;

Vos, Jan A. ;

Mulder, Maxim J. H. L. ;

Goldhoorn, Robert-Jan B. ;

Kappelhof, Manon ;

Schonewille, Wouter J. ;

Wermer, Marieke J. H. ;

van Walderveen, Marianne A. A. ;

Staals, Julie ;

Hofmeijer, Jeannette ;

Martens, Jasper M. ;

Nijeholt, Geert J. Lycklama A. ;

Roozenbeek, Bob ;

de Bruijn, Sebastiaan F. ;

van Dijk, Lukas C. ;

Lo, Rob H. ;

van Dijk, Ewoud J. ;

Boogaarts, Hieronymus D. ;

de Kort, Paul L. M. ;

Peluso, Jo P. ;

van den Berg, Jan S. P. ;

van Hasselt, Boudewijn A. A. M. ;

Aerden, Leo A. M. ;

Dallinga, Rene J. ;

Uyttenboogaart, Maarten ;

Eshghi, Omid ;

Schreuder, Tobien H. C. M. L. ;

Heijboer, Roel J. J. ;

Keizer, Koos ;

Yo, Lonneke S. F. ;

den Hertog, Heleen M. ;

Sturm, Emiel J. C. .

STROKE, 2019, 50 (12) :3360-3368

[10] Identifying Patients at High Risk for Poor Outcome After Intra-Arterial Therapy for Acute Ischemic Stroke [J].

Hallevi, Hen ;

Barreto, Andrew D. ;

Liebeskind, David S. ;

Morales, Miriam M. ;

Martin-Schild, Sheryl B. ;

Abraham, Anitha T. ;

Gadia, Jignesh ;

Saver, Jeffrey L. ;

Grotta, James C. ;

Savitz, Sean I. .

STROKE, 2009, 40 (05) :1780-1785

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