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논문 기본 정보

자료유형
학술저널
저자정보
Young Dae Kim (Department of Neurology Yonsei University College of Medicine Seoul Korea) Hyo Suk Nam (Department of Neurology Yonsei University College of Medicine Seoul Korea) Joonsang Yoo (Keimyung University School of Medicine Daegu Korea) Hyungjong Park (Department of Neurology Yonsei University College of Medicine Seoul Korea) Sung-Il Sohn (Keimyung University School of Medicine Daegu Korea) Jeong-Ho Hong (Keimyung University School of Medicine Daegu Korea) Byung Moon Kim (Yonsei University College of Medicine Seoul Korea) Dong Joon Kim (Yonsei University College of Medicine Seoul Korea) Oh Young Bang (Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea) Woo-Keun Seo (Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea) Jong-Won Chung (Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea) Kyung-Yul Lee (Yonsei University College of Medicine Seoul Korea) Yo Han Jung (Yonsei University College of Medicine Seoul Korea) Hye Sun Lee (Yonsei University College of Medicine Seoul Korea) Seong Hwan Ahn (Chosun University College of Medicine Gwangju Korea) Dong Hoon Shin (Gachon University Gil Medical Center Incheon Korea) Hye-Yeon Choi (Kyung Hee University Hospital at Gangdong Seoul Korea) Han-Jin Cho (Pusan National University School of Medicine Busan Korea) Jang-Hyun Baek (National Medical Center Seoul Korea) Gyu Sik Kim (National Health Insurance Service Ilsan Hospital Goyang Korea) Kwon-Duk Seo (National Health Insurance Service Ilsan Hospital Goyang Korea) Seo Hyun Kim (Yonsei University Wonju College of Medicine Wonju Korea) Tae-Jin Song (Ewha Womans University Mokdong HospitalSeoul Korea) Jinkwon Kim (Yongin Severance Hospital Yongin Korea) Sang Won Han (Inje University Sanggye Paik Hospital Seoul Korea) Joong Hyun Park (Inje University Sanggye Paik HospitalSeoul Korea) Sung Ik Lee (Wonkwang University Sanbon HospitalSanbon Korea) JoonNyung Heo (Yonsei University College of Medicine Seoul Korea) Jin Kyo Choi (Yonsei University College of Medicine Seoul Korea) Ji Hoe Heo (Yonsei University College of Medicine Seoul Korea)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제23권 제2호
발행연도
2021.1
수록면
244 - 252 (9page)

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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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