Radiologic Cerebral Reperfusion at 24  h Predicts Good Clinical Outcome

AbstractCerebral reperfusion and arterial recanalization are radiological features of the effectiveness of thrombolysis in acute ischemic stroke (AIS) patients. Here, an investigation of the prognostic role of early recanalization/reperfusion on clinical outcome was performed. In AIS patients (n = 55), baseline computerized tomography (CT) was performed ≤ 8 h from symptom onset, whereas CT determination of reperfusion/recanalization was assessed at 24 h. Multiple linear and logistic regression models were used to correlate reperfusion/recanalization with radiological (i.e., hemor rhagic transformation, ischemic core, and penumbra volumes) and clinical outcomes (assessed as National Institutes of Health Stroke Scale [NIHSS] reduction ≥ 8 points or a NIHSS ≤ 1 at 24 h and as modified Rankin Scale [mRS]<  2 at 90 days). At 24 h, patients achieving radiological reperfusion weren = 24, while the non-reperfused weren = 31. Among non-reperfused,n = 15 patients were recanalized. Radiological reperfusion vs. recanalization was also confirmed by early increased levels of circulating inflammatory biomarkers (i.e., serum osteopontin). In multivariate analysis, ischemic lesion volume reduction was associated with both recanalization (β = 0.265;p = 0.014) and reperfusion (β = 0.461;p <  0.001), but only reperfusion was independently associated with final infarct volume (β = − 0.333;p = 0.007). Only radiological reperfu...
Source: Translational Stroke Research - Category: Neurology Source Type: research