Does Clot Burden Score on Baseline T2*-MRI Impact Clinical Outcome in Acute Ischemic Stroke Treated with Mechanical Thrombectomy?

被引：30

作者：

Derraz, Imad ^{[1
]}

Bourcier, Romain ^{[2
,22
]}

Soudant, Marc ^{[3
]}

Soize, Sebastien ^{[4
,48
]}

Ben Hassen, Wagih ^{[5
,6
]}

Hossu, Gabriella ^{[7
]}

Clarencon, Frederic ^{[8
,17
,24
]}

Derelle, Anne Laure ^{[1
]}

Tisserand, Marie ^{[9
,33
,34
]}

Raoult, Helene ^{[10
,42
]}

Legrand, Laurence ^{[5
,6
]}

Bracard, Serge ^{[1
]}

Oppenheim, Catherine ^{[5
,6
]}

Naggara, Olivier ^{[5
,6
,33
,34
]}

Bonafe, Alain ^{[11
]}

Leclerc, Xavier ^{[12
]}

Agrinier, Nelly ^{[13
,14
]}

Bakchine, Serge ^{[15
]}

Baronnet, Flore ^{[16
,17
]}

Beaumont, Marine ^{[14
,18
]}

Bejot, Yannick ^{[19
]}

Berge, Jerome ^{[20
]}

Bintner, Marc ^{[21
]}

Cho, Tae Hee ^{[23
]}

Cogez, Julien ^{[25
]}

Cordonnier, Charlotte ^{[26
]}

Denier, Christian ^{[27
]}

Detante, Olivier ^{[28
]}

Faivre, Anthony ^{[29
]}

Ferrier, Anne ^{[30
]}

Gimenez, Laetitia ^{[31
]}

Godard, Sophie ^{[32
]}

Boulouis, Gregoire ^{[33
,34
]}

Guillon, Benoit ^{[23
]}

Houdart, Emmanuel ^{[35
]}

Lapergue, Bertrand ^{[36
]}

Musacchio, Mariano ^{[37
]}

Neau, Jean Philippe ^{[38
]}

Obadia, Michael ^{[39
]}

Pasco-Papon, Anne ^{[40
]}

Piotin, Michel ^{[41
]}

Pierot, Laurent ^{[42
]}

Richard, Sebastien ^{[43
]}

Ricolfi, Frederic ^{[44
]}

Ronziere, Thomas ^{[45
]}

Saliou, Guillaume ^{[46
]}

Sibon, Igor ^{[47
]}

Sedat, Jacques ^{[49
]}

Stapf, Christian ^{[50
]}

Suissa, Laurent ^{[51
]}

机构：

[1] Univ Lorraine, CHRU Nancy, Dept Neuroradiol, INSERM, Nancy, France

[2] CHU Nantes, Dept Neuroradiol, Nantes, France

[3] Univ Lorraine, CHRU Nancy, Dept Biostat, INSERM, Nancy, France

[4] CHU Reims, Dept Neuroradiol, Reims, France

[5] Paris Descartes Univ, INSERM UMR 894, 1 Rue Cabanis, F-75014 Paris, France

[6] St Anne Hosp Ctr, Dept Neuroradiol, 1 Rue Cabanis, F-75014 Paris, France

[7] Univ Lorraine, INSERM, CHRU Nancy, Dept CIC1433 Innovat Technol, Nancy, France

[8] Hop La Pitie Salpetriere, Dept Neuroradiol, Paris, France

[9] Foch Hosp, Dept Neuroradiol, Suresnes, France

[10] CHU Rennes, Dept Neuroradiol, Rennes, France

[11] Gui de Chauliac Hosp, Dept Neuroradiol, Montpellier, France

[12] Univ Hosp Lille, Dept Radiol, Lille, France

[13] Univ Lorraine, INSERM CIC EC 1433, Dept Clin Epidemiol, Nancy, France

[14] Univ Hosp Nancy, Nancy, France

[15] Univ Hosp Reims, Dept Neurol, Reims, France

[16] Pitie Salpetriere Hosp Grp, Stroke Unit, Paris, France

[17] Paris 6 Univ Pierre & Marie Curie, Paris, France

[18] Univ Lorraine, Dept INSERM CIC IT, Nancy, France

[19] Univ Hosp Dijon, Dept Neurol, Dijon, France

[20] Univ Hosp Bordeaux, Dept Intervent & Diagnost Neuroradiol, Bordeaux, France

[21] Sud Reunion Hosp Grp, Dept Neuroradiol, St Pierre, Reunion, France

[22] Univ Hosp Nantes, Dept Intervent & Diagnost Neuroradiol, Nantes, France

[23] Univ Hosp Lyon, Dept Neurol, Lyon, France

[24] Pitie Salpetriere Hosp Grp, Dept Intervent Neuroradiol, Paris, France

[25] Univ Hosp Caen, Dept Neurol, Caen, France

[26] Univ Hosp Lille, Dept Neurol, Lille, France

[27] Univ Hosp Bicetre, Dept Neurol, Le Kremlin Bicetre, France

[28] Univ Hosp Nancy, Dept Diagnost & Intervent Neuroradiol, Nancy, France

[29] Hop Instruct Armees, Dept Neurol, Toulon, France

[30] Univ Hosp Gabriel Montpied, Dept Neurol, Clermont Ferrand, France

[31] Univ Hosp Limoges, Dept Neurol, Limoges, France

[32] Univ Hosp Angers, Dept Neurol, Angers, France

[33] St Anne Hosp, Dept Neuroradiol, Paris, France

[34] Paris Descartes Univ, INSERM U894, Paris, France

[35] Univ Hosp Lariboisiere, Dept Neuroradiol, Paris, France

[36] Foch Hosp, Dept Neurol, Suresnes, France

[37] Pasteur Hosp, Dept Neuroradiol, Colmar, France

[38] Univ Hosp Poitiers, Dept Neurol, Poitiers, France

[39] Rothschild Ophthalmol Fdn, Dept Neurol, Paris, France

[40] Univ Hosp Angers, Dept Radiol, Angers, France

[41] Rothschild Ophthalmol Fdn, Dept Intervent Neuroradiol, Paris, France

[42] Univ Hosp Reims, Dept Neuroradiol, Reims, France

[43] Univ Hosp Nancy, Dept Neurol, Nancy, France

[44] Univ Hosp Dijon, Dept Neuroradiol, Dijon, France

[45] Univ Hosp Rennes, Dept Neurol, Rennes, France

[46] Univ Hosp Bicetre, Dept Neuroradiol, Le Kremlin Bicetre, France

[47] Univ Hosp Bordeaux, Dept Neurol, Bordeaux, France

[48] Univ Hosp Reims, Dept Neuroradiol, Reims, France

[49] Univ Hosp Nice, Dept Radiol, Nice, France

[50] Univ Hosp Lariboisiere, Dept Neurol, Paris, France

来源：

JOURNAL OF STROKE | 2019年 / 21卷 / 01期

关键词：

Ischemic stroke; Magnetic resonance imaging; Thrombosis; Endovascular recanalization; SUSCEPTIBILITY VESSEL SIGN; STENT-RETRIEVER; ENDOVASCULAR TREATMENT; THROMBUS LENGTH; ASPIRATION THROMBECTOMY; INTRAARTERIAL TREATMENT; INTRAVENOUS ALTEPLASE; CONTACT ASPIRATION; CT ANGIOGRAPHY; RECANALIZATION;

D O I：

10.5853/jos.2018.01921

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose A long clot, defined by a low (0-6) clot burden score (CBS) assessed by T2*-MR sequence, is associated with worse clinical outcome after intravenous thrombolysis (IVT) for acute ischemic stroke than is a small clot (CBS, 7-10). The added benefit of mechanical thrombectomy (MT) might be higher in patients with long clot. The aim of this pre-specified post hoc analysis of the THRombectomie des Arteres CErebrales (THRACE) trial was to assess the association between T2*-CBS, successful recanalization and clinical outcome. Methods Of 414 patients randomized in the THRACE trial, 281 patients were included in this analysis. Associations between T2*-CBS and clinical outcome on the modified Rankin Scale (mRS) at 3 months were tested. Results High T2*-CBS, i.e., small clot, was associated with a shift toward better outcome on the mRS; proportional odds ratio (POR) per point CBS was 1.19 (95% confidence interval [CI], 1.05 to 1.34) in the whole population, 1.34 (95% CI, 1.13 to 1.59) in IVT group, and 1.04 (95% CI, 0.87 to 1.23) in IVTMT group. After adjustment for baseline prognostic variables, the effect of the full scale T2*-CBS was not statistically significant in the whole population and for the IVTMT group but remains significant for the IVT group (POR, 1.32; 95% CI, 1.11 to 1.58). Conclusions A small clot, as assessed using T2*-CBS, is associated with improved outcome and may be used as a prognostic marker. Despite the worst outcome with long clot, the relative benefit of MT over IVT seemed to increase with low T2*-CBS and longer clot.

引用

页码：91 / +

页数：12

共 31 条

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