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Transcranial Doppler 6 h after Successful Reperfusion as a Predictor of Infarct Volume.

Authors
  • Gómez-Escalonilla, Carlos1
  • Simal, Patricia2
  • García-Moreno, Hector3
  • Sánchez, Talía Liaño4
  • Canalejo, Diego Mayo5
  • Jiménez, María Romeral6
  • Hernández, Lorenzo Silva7
  • Alfocea, Daniel Toledo8
  • Moreu, Manuel9
  • Pérez-García, Carlos9
  • Rosati, Santiago9
  • Egido, Jose Antonio2
  • 1 Stroke Unit, Neurology Department, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, Madrid, 28040, Spain. Electronic address: [email protected] , (Spain)
  • 2 Stroke Unit, Neurology Department, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, Madrid, 28040, Spain. , (Spain)
  • 3 Department of Clinical and Movement Neurosciences, University College London, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, United Kingdom. Electronic address: [email protected] , (United Kingdom)
  • 4 Neurology, Complejo Hospitalario Ruber Juan Bravo, Calle Juan Bravo 39, Madrid, 28006, Spain. , (Spain)
  • 5 Neurology, Hospital Universitario de Móstoles, Rio Jucar S/N, Móstoles, 28935, Spain. , (Spain)
  • 6 Neurology, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, Madrid, 28040, Spain. , (Spain)
  • 7 Neurology, Hospital Universitario Puerta de Hierro, C/Manuel de Falla 2, Majadahonda, 28222, Spain. Electronic address: [email protected] , (Spain)
  • 8 Neurology, Hospital Universitario 12 de Octubre, Av de Córdoba, s/n, Madrid, 28041, Spain. , (Spain)
  • 9 Interventional Neuroradiology, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, Madrid, 28040, Spain. , (Spain)
Type
Published Article
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
Publication Date
Oct 20, 2021
Volume
31
Issue
1
Pages
106149–106149
Identifiers
DOI: 10.1016/j.jstrokecerebrovasdis.2021.106149
PMID: 34688211
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The aim of the study is to analyze the hemodynamic changes in the middle cerebral artery (MCA) after endovascular revascularization in acute ischemic stroke (AIS) due to large vessel occlusion and its association with the infarct volume size in the control head CT. Prospective study of patients with AIS due to internal carotid artery terminus or M1 segment of the MCA occlusion, who underwent endovascular treatment with a final TICI 2b-3 score, without concomitant stenosis ≥50% in both cervical carotid arteries. Transcranial Doppler ultrasound (TCD) of both MCAs was carried out at 6 h after the endovascular procedure. Mean flow velocities (MFV) after arterial reperfusion and its association with the infarct volume size in 24-36 h control head CT were determined. 91 patients (51 women) were included with a median age of 78 years and National institute of Health Stroke Scale of 18. The MCA was occluded in 76.92%, and intravenous thrombolysis was administered in 40.7%. The incidence of symptomatic intracranial hemorrhage was 5.5%. At three months, mortality was 19.8% and a 52.7% of patients achieved functional independence (modified Rankin Scale 0-2). After a multivariable logistic regression analysis, an increase in the MFV greater than 50% at 6 h in the treated MCA compared to contralateral MCA, was an independent predictor of large infarct volume in the control head CT with an OR 9.615 (95%CI: 1.908-47.620), p=0.006 CONCLUSIONS: Increased MFV assessed by TCD examination following endovascular recanalization is independently associated with larger infarct volume. Copyright © 2021 Elsevier Inc. All rights reserved.

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