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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Background and Purpose We aimed to develop a model predicting early recanalization after intravenous tissue plasminogen activator (t-PA) treatment in large-vessel occlusion. Methods Using data from two different multicenter prospective cohorts, we determined the factors associated with early recanalization immediately after t-PA in stroke patients with large-vessel occlusion, and developed and validated a prediction model for early recanalization. Clot volume was semiautomatically measured on thin-section computed tomography using software, and the degree of collaterals was determined using the Tan score. Follow-up angiographic studies were performed immediately after t-PA treatment to assess early recanalization. Results Early recanalization, assessed 61.0±44.7 minutes after t-PA bolus, was achieved in 15.5% (15/97) in the derivation cohort and in 10.5% (8/76) in the validation cohort. Clot volume (odds ratio [OR], 0.979; 95% confidence interval [CI], 0.961 to 0.997; P=0.020) and good collaterals (OR,6.129; 95% CI, 1.592 to 23.594; P=0.008) were significant factors associated with early recanalization. The area under the curve (AUC) of the model including clot volume was 0.819 (95% CI, 0.720 to 0.917) and 0.842 (95% CI, 0.746 to 0.938) in the derivation and validation cohorts, respectively. The AUC improved when good collaterals were added (derivation cohort: AUC, 0.876; 95% CI, 0.802 to 0.950; P=0.164; validation cohort: AUC, 0.949; 95% CI, 0.886 to 1.000; P=0.036). The integrated discrimination improvement also showed significantly improved prediction (0.097; 95% CI, 0.009 to 0.185; P=0.032). Conclusions The model using clot volume and collaterals predicted early recanalization after intravenous t-PA and had a high performance. This model may aid in determining the recanalization treatment strategy in stroke patients with large-vessel occlusion.
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참고문헌 (25)
참고문헌 신청
Goyal M / 2016 / Endovascular thrombectomy after large-vessel ischaemic stroke : a meta-analysis of individual patient data from five randomised trials / Lancet 387:1723~1731
Powers WJ / 2019 / Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke. A guideline for healthcare professionals from the American Heart Association/American Stroke Association / Stroke 50:e344~e418
Lee KY / 2007 / Early recanalization after intravenous administration of recombinant tissue plasminogen activator as assessed by preand post-thrombolytic angiography in acute ischemic stroke patients / Stroke 38:192~193
Campbell BCV / 2018 / Tenecteplase versus alteplase before thrombectomy for ischemic stroke / N Engl J Med 378:1573~1582
Yoo J / 2018 / Thrombus volume as a predictor of nonrecanalization after intravenous thrombolysis in acute stroke / Stroke 49:2108~2115
Powers WJ / 2019 / Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke. A guideline for healthcare professionals from the American Heart Association/American Stroke Association / Stroke 50:e344~e418
Lee KY / 2007 / Early recanalization after intravenous administration of recombinant tissue plasminogen activator as assessed by preand post-thrombolytic angiography in acute ischemic stroke patients / Stroke 38:192~193
Campbell BCV / 2018 / Tenecteplase versus alteplase before thrombectomy for ischemic stroke / N Engl J Med 378:1573~1582
Yoo J / 2018 / Thrombus volume as a predictor of nonrecanalization after intravenous thrombolysis in acute stroke / Stroke 49:2108~2115
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