Thrombus Volume as a Predictor of Nonrecanalization After Intravenous Thrombolysis in Acute Stroke
Thrombus Volume as a Predictor of Nonrecanalization After Intravenous Thrombolysis in Acute Stroke
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DOI：
10.1161/strokeaha.118.021864
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发表时间：
2018-09-01
期刊：
影响因子：
8.3
通讯作者：
Heo, Ji Hoe
中科院分区：
文献类型：
--
作者：
Yoo, Joonsang;Baek, Jang-Hyun;Heo, Ji Hoe
背景和目的-我们调查是否测量血栓的体积和密度可以预测nonrecanalization after intravenous thrombolysis. Methods-这项研究包括一个回顾性队列，以开发一个计算机断层扫描标记的血栓预测nonrecanalization after intravenous thrombolysis和一个前瞻性多中心队列验证这个标记。血栓的体积和密度使用三维软件在基线薄切片非造影计算机断层扫描（1或1.25 mm）上半自动测量。在静脉溶栓后立即通过计算机断层扫描血管造影术或磁共振血管造影术或接受进一步动脉内治疗的患者的常规血管造影术评估再通。未再通定义为脑梗死改良溶栓0、1、2a级。结果在回顾性队列中，214例患者中有162例（76.7%）未能实现再通。未再通患者的血栓体积明显大于成功再通患者（149.5 ± 127.6 vs 65.3 ± 58.3 mm（3）; P
Background and Purpose-We investigated whether measuring the volume and density of a thrombus could predict nonrecanalization after intravenous thrombolysis.Methods-This study included a retrospective cohort to develop a computed tomography marker of thrombus for predicting nonrecanalization after intravenous thrombolysis and a prospective multicenter cohort for validation of this marker. The volume and density of thrombus were measured semiautomatically using 3-dimensional software on a baseline thin-section noncontrast computed tomography (1 or 1.25 mm). Recanalization was assessed on computed tomography angiography or magnetic resonance angiography immediately after intravenous thrombolysis or conventional angiography in patients who underwent further intra-arterial treatment. Nonrecanalization was defined as a modified Thrombolysis in Cerebral Infarction grade 0, 1, 2a.Results-In the retrospective cohort, 162 of 214 patients (76.7%) failed to achieve recanalization. The thrombus volume was significantly larger in patients with nonrecanalization than in those with successful recanalization (149.5 +/- 127.6 versus 65.3 +/- 58.3 mm(3); P