التفاصيل البيبلوغرافية
| العنوان: |
Impact of leukoaraiosis in patients with acute ischemic stroke treated with thrombectomy: a post hoc analysis of the DIRECT-MT trial. |
| المؤلفون: |
Tingyu Yi, Yongxin Zhang, Wen-huo Chen, Yan-min Wu, Ding-lai Lin, Xiao-hui Lin, Lei Zhang, Peng-fei Xing, Tianxiao Li, Yongwei Zhang, Shouchun Wang, Pengfei Yang, Ming-zhi Cai, Jianmin Liu |
| المصدر: |
Journal of NeuroInterventional Surgery; Feb2023, Vol. 15 Issue 2, p139-145, 8p |
| مصطلحات موضوعية: |
SURGICAL complication risk factors, BRAIN, STATISTICS, CONFIDENCE intervals, BLOOD vessels, ISCHEMIC stroke, CONVALESCENCE, INTRACRANIAL hemorrhage, CEREBRAL infarction, CEREBRAL circulation, MANN Whitney U Test, FISHER exact test, REGRESSION analysis, TREATMENT effectiveness, RANDOMIZED controlled trials, FUNCTIONAL assessment, SEVERITY of illness index, T-test (Statistics), THROMBECTOMY, DESCRIPTIVE statistics, CHI-squared test, RESEARCH funding, STATISTICAL sampling, DATA analysis, ODDS ratio, COMPUTED tomography, DATA analysis software, LOGISTIC regression analysis, NEUROLOGIC examination, DISEASE risk factors |
| مصطلحات جغرافية: |
CHINA |
| مستخلص: |
Background The influence of leukoaraiosis in patients with acute ischemic stroke (AIS) given intra-arterial treatment (IAT) with or without preceding intravenous thrombolysis (IVT) remains unknown. Objective To assess the clinical and radiological outcomes of IAT in patients with or without leukoaraiosis. Methods Patients of the direct mechanical thrombectomy trial (DIRECT-MT) whose leukoaraiosis grade could be assessed were included. DIRECT-MT was a randomized clinical trial performed in China to assess the effect of direct IAT compared with intravenous thrombolysis plus IAT. We employed the Age-Related White Matter Changes Scale for grading leukoaraiosis (ARWMC, 0 indicates no leukoaraiosis, 1-2 indicates mild-to-moderate leukoaraiosis, and 3 indicates severe leukoaraiosis) based on brain CT. The primary outcome was the score on the modified Rankin Scale (mRS) assessed at 90 days. Results There were 656 patients in the trial, 649 patients who were included, with 432 patients without leukoaraiosis, and 217 (33.4%) patients with leukoaraiosis divided into mild-to-moderate (n=139) and severe groups (n=78). Leukoaraiosis was a predictor of a worse mRS score (adjusted OR (aOR)=0.7 (95% CI 0.5 to 0.8)) and higher mortality (aOR=1.4 (1.1 to 1.9)), but it was not associated with symptomatic intracranial hemorrhage (sICH) (aOR=0.9 (0.5 to 1.5)). IVT preceding IAT did not increase sICH risk for patients with no (aOR=1.4 (0.6 to 3.4)), mild-to-moderate (aOR=1.5 (0.3 to 7.8)), or severe (aOR=1.5 (0.1 to 21.3)) leukoaraiosis. Conclusion Patients with leukoaraiosis with AIS due to large vessel occlusion are at increased risk of a poor functional outcome after IAT but demonstrate similar sICH rates, and IVT preceding IAT does not increase the risk of sICH in Chinese patients with leukoaraiosis. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |