Combined Use of X-ray Angiography and Intraprocedural MRI Enables Tissue-based Decision Making Regarding Revascularization during Acute Ischemic Stroke Intervention
| العنوان: | Combined Use of X-ray Angiography and Intraprocedural MRI Enables Tissue-based Decision Making Regarding Revascularization during Acute Ischemic Stroke Intervention |
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| المؤلفون: | Christopher F. Dowd, Jonathan Massachi, Kazim H. Narsinh, Kerstin Mueller, Alexander Copelan, Jeffrey R. Vitt, Steven W. Hetts, Chung-Huan Sun, Van V. Halbach, Matthew R Amans, Daniel L Cooke, Himanshu Bhat, Mark W. Wilson, Daniel Murph, T Moore, Randall T. Higashida, B Kilbride |
| المصدر: | Radiology, vol 299, iss 1 |
| بيانات النشر: | Radiological Society of North America (RSNA), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, medicine.medical_treatment, Decision Making, Revascularization, Medical and Health Sciences, 030218 nuclear medicine & medical imaging, Intraoperative Period, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Clinical Research, Interquartile range, Antithrombotic, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Fisher's exact test, Aged, Ischemic Stroke, Retrospective Studies, Thrombectomy, medicine.diagnostic_test, business.industry, Neurosciences, Infant, Newborn, Infant, Retrospective cohort study, Middle Aged, Newborn, Magnetic Resonance Imaging, Brain Disorders, Cerebral Angiography, Stroke, Nuclear Medicine & Medical Imaging, Blood pressure, 030220 oncology & carcinogenesis, Angiography, symbols, Biomedical Imaging, Female, Radiology, business |
| الوصف: | Background For patients with acute ischemic stroke undergoing endovascular mechanical thrombectomy with x-ray angiography, the use of adjuncts to maintain vessel patency, such as stents or antiplatelet medications, can increase risk of periprocedural complications. Criteria for using these adjuncts are not well defined. Purpose To evaluate use of MRI to guide critical decision making by using a combined biplane x-ray neuroangiography 3.0-T MRI suite during acute ischemic stroke intervention. Materials and Methods This retrospective observational study evaluated consecutive patients undergoing endovascular intervention for acute ischemic stroke between July 2019 and May 2020 who underwent either angiography with MRI or angiography alone. Cerebral tissue viability was assessed by using MRI as the reference standard. For statistical analysis, Fisher exact test and Student t test were used to compare groups. Results Of 47 patients undergoing acute stroke intervention, 12 patients (median age, 69 years; interquartile range, 60-77 years; nine men) underwent x-ray angiography with MRI whereas the remaining 35 patients (median age, 80 years; interquartile range, 68-86 years; 22 men) underwent angiography alone. MRI results influenced clinical decision making in one of three ways: whether or not to perform initial or additional mechanical thrombectomy, whether or not to place an intracranial stent, and administration of antithrombotic or blood pressure medications. In this initial experience, decision making during endovascular acute stroke intervention in the combined angiography-MRI suite was better informed at MRI, such that therapy was guided in real time by the viability of the at-risk cerebral tissue. Conclusion Integrating intraprocedural 3.0-T MRI into acute ischemic stroke treatment was feasible and guided decisions of whether or not to continue thrombectomy, to place stents, or to administer antithrombotic medication or provide blood pressure medications. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Lev and Leslie-Mazwi in this issue. |
| وصف الملف: | application/pdf |
| تدمد: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.2021202750 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f121577403267394adc57f0583e145f8 https://doi.org/10.1148/radiol.2021202750 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f121577403267394adc57f0583e145f8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15271315 00338419 |
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| DOI: | 10.1148/radiol.2021202750 |