Angiographic Microcirculatory Obstructions Distal to Occlusion Signify Poor Outcome after Endovascular Treatment for Acute Ischemic Stroke
The success of endovascular therapies depends on a number of factors including flow dynamics proximal and distal to the occlusion. The evaluation of antegrade flow distal to the occluded segment is currently a readily available, yet unexplored, option during stentriever-mediated thrombectomy. In thi...
Gespeichert in:
| Veröffentlicht in: | Translational stroke research 2018-02, Vol.9 (1), p.44-50 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 50 |
|---|---|
| container_issue | 1 |
| container_start_page | 44 |
| container_title | Translational stroke research |
| container_volume | 9 |
| creator | Arsava, Ethem Murat Arat, Anil Topcuoglu, Mehmet Akif Peker, Ahmet Yemisci, Muge Dalkara, Turgay |
| description | The success of endovascular therapies depends on a number of factors including flow dynamics proximal and distal to the occlusion. The evaluation of antegrade flow distal to the occluded segment is currently a readily available, yet unexplored, option during stentriever-mediated thrombectomy. In this study, we retrospectively evaluated presence of contrast stasis and absence of capillary blush on angiograms obtained by selective injections into the distal site of occlusive thrombi, prior to deployment of stentrievers, in patients undergoing endovascular treatment for acute MCA occlusion. The role of this novel angiographic strategy assessing distal antegrade flow in predicting procedural and clinical outcome was compared to previously defined, prognostic angiographic characteristics. A total of 7 (21%) out of 34 patients had contrast stasis and lack of capillary blush downstream to the injection site. None of these patients with angiographic features suggestive of microcirculatory obstructions achieved a satisfactory outcome in terms of reperfusion (TICI grade 2B–C) and clinical outcome (90-day mRS 0–2), while the corresponding figures were 78% (
p
|
| doi_str_mv | 10.1007/s12975-017-0562-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1930933007</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1930933007</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-425edd76b7b2e647e093b1b66756bb510b2f87de8349b9d3d5a11757805827f73</originalsourceid><addsrcrecordid>eNp1kV1rFDEUhoMottT-AG8k4I03U_MxmWQul1q1UFmhFbwLSebMNnVmsuajsH_BX22W3SoI5iYhec57wnkQek3JBSVEvk-U9VI0hMqGiI417Bk6papTTUfo9-fHc9sqfoLOU3ogdXHadi1_iU6YUkwwxk_Rr9Wy8WETzfbeO_zFuxicj65MJoe4w2ubciwu-7Ak_MGnbCacA147N5VUL_Gt3yx-3OGvIUS8LtmFGbAZM0R8tQzh0aR9VsR3EUyeYcl4rODKlQz4Orl7mGvb2xzDD3iFXoxmSnB-3M_Qt49Xd5efm5v1p-vL1U3jWq5y0zIBwyA7Ky2DrpVAem6p7TopOmsFJZaNSg6geNvbfuCDMJRKIRURislR8jP07pC7jeFngZT17JODaTILhJI07XmN5HXGFX37D_oQSlzq7zTraS-IInxP0QNVh5dShFFvo59N3GlK9N6VPrjS1ZXeu9Ks1rw5Jhc7w_Cn4slMBdgBSPVp2UD82_r_qb8Bu-mgJA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2919508037</pqid></control><display><type>article</type><title>Angiographic Microcirculatory Obstructions Distal to Occlusion Signify Poor Outcome after Endovascular Treatment for Acute Ischemic Stroke</title><source>ProQuest Central (Alumni Edition)</source><source>ProQuest Central UK/Ireland</source><source>SpringerLink Journals - AutoHoldings</source><source>ProQuest Central</source><creator>Arsava, Ethem Murat ; Arat, Anil ; Topcuoglu, Mehmet Akif ; Peker, Ahmet ; Yemisci, Muge ; Dalkara, Turgay</creator><creatorcontrib>Arsava, Ethem Murat ; Arat, Anil ; Topcuoglu, Mehmet Akif ; Peker, Ahmet ; Yemisci, Muge ; Dalkara, Turgay</creatorcontrib><description>The success of endovascular therapies depends on a number of factors including flow dynamics proximal and distal to the occlusion. The evaluation of antegrade flow distal to the occluded segment is currently a readily available, yet unexplored, option during stentriever-mediated thrombectomy. In this study, we retrospectively evaluated presence of contrast stasis and absence of capillary blush on angiograms obtained by selective injections into the distal site of occlusive thrombi, prior to deployment of stentrievers, in patients undergoing endovascular treatment for acute MCA occlusion. The role of this novel angiographic strategy assessing distal antegrade flow in predicting procedural and clinical outcome was compared to previously defined, prognostic angiographic characteristics. A total of 7 (21%) out of 34 patients had contrast stasis and lack of capillary blush downstream to the injection site. None of these patients with angiographic features suggestive of microcirculatory obstructions achieved a satisfactory outcome in terms of reperfusion (TICI grade 2B–C) and clinical outcome (90-day mRS 0–2), while the corresponding figures were 78% (
p
< 0.001) and 48% (
p
= 0.029), respectively, among patients with substantial capillary filling. These findings highlight the potentially detrimental impact of impaired microcirculatory flow on tissue and clinical outcome after recanalization/reperfusion efforts in acute ischemic stroke.</description><identifier>ISSN: 1868-4483</identifier><identifier>EISSN: 1868-601X</identifier><identifier>DOI: 10.1007/s12975-017-0562-2</identifier><identifier>PMID: 28825223</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Biomedical and Life Sciences ; Biomedicine ; Blood clots ; Cardiology ; Clinical outcomes ; Ischemia ; Medical imaging ; Neurology ; Neurosciences ; Neurosurgery ; Original Article ; Patients ; Stroke ; Success ; Tomography ; Vascular Surgery</subject><ispartof>Translational stroke research, 2018-02, Vol.9 (1), p.44-50</ispartof><rights>Springer Science+Business Media, LLC 2017</rights><rights>Springer Science+Business Media, LLC 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-425edd76b7b2e647e093b1b66756bb510b2f87de8349b9d3d5a11757805827f73</citedby><cites>FETCH-LOGICAL-c438t-425edd76b7b2e647e093b1b66756bb510b2f87de8349b9d3d5a11757805827f73</cites><orcidid>0000-0002-6527-4139</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12975-017-0562-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2919508037?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21388,21389,27924,27925,33530,33531,33744,33745,41488,42557,43659,43805,51319,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28825223$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arsava, Ethem Murat</creatorcontrib><creatorcontrib>Arat, Anil</creatorcontrib><creatorcontrib>Topcuoglu, Mehmet Akif</creatorcontrib><creatorcontrib>Peker, Ahmet</creatorcontrib><creatorcontrib>Yemisci, Muge</creatorcontrib><creatorcontrib>Dalkara, Turgay</creatorcontrib><title>Angiographic Microcirculatory Obstructions Distal to Occlusion Signify Poor Outcome after Endovascular Treatment for Acute Ischemic Stroke</title><title>Translational stroke research</title><addtitle>Transl. Stroke Res</addtitle><addtitle>Transl Stroke Res</addtitle><description>The success of endovascular therapies depends on a number of factors including flow dynamics proximal and distal to the occlusion. The evaluation of antegrade flow distal to the occluded segment is currently a readily available, yet unexplored, option during stentriever-mediated thrombectomy. In this study, we retrospectively evaluated presence of contrast stasis and absence of capillary blush on angiograms obtained by selective injections into the distal site of occlusive thrombi, prior to deployment of stentrievers, in patients undergoing endovascular treatment for acute MCA occlusion. The role of this novel angiographic strategy assessing distal antegrade flow in predicting procedural and clinical outcome was compared to previously defined, prognostic angiographic characteristics. A total of 7 (21%) out of 34 patients had contrast stasis and lack of capillary blush downstream to the injection site. None of these patients with angiographic features suggestive of microcirculatory obstructions achieved a satisfactory outcome in terms of reperfusion (TICI grade 2B–C) and clinical outcome (90-day mRS 0–2), while the corresponding figures were 78% (
p
< 0.001) and 48% (
p
= 0.029), respectively, among patients with substantial capillary filling. These findings highlight the potentially detrimental impact of impaired microcirculatory flow on tissue and clinical outcome after recanalization/reperfusion efforts in acute ischemic stroke.</description><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Blood clots</subject><subject>Cardiology</subject><subject>Clinical outcomes</subject><subject>Ischemia</subject><subject>Medical imaging</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Patients</subject><subject>Stroke</subject><subject>Success</subject><subject>Tomography</subject><subject>Vascular Surgery</subject><issn>1868-4483</issn><issn>1868-601X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kV1rFDEUhoMottT-AG8k4I03U_MxmWQul1q1UFmhFbwLSebMNnVmsuajsH_BX22W3SoI5iYhec57wnkQek3JBSVEvk-U9VI0hMqGiI417Bk6papTTUfo9-fHc9sqfoLOU3ogdXHadi1_iU6YUkwwxk_Rr9Wy8WETzfbeO_zFuxicj65MJoe4w2ubciwu-7Ak_MGnbCacA147N5VUL_Gt3yx-3OGvIUS8LtmFGbAZM0R8tQzh0aR9VsR3EUyeYcl4rODKlQz4Orl7mGvb2xzDD3iFXoxmSnB-3M_Qt49Xd5efm5v1p-vL1U3jWq5y0zIBwyA7Ky2DrpVAem6p7TopOmsFJZaNSg6geNvbfuCDMJRKIRURislR8jP07pC7jeFngZT17JODaTILhJI07XmN5HXGFX37D_oQSlzq7zTraS-IInxP0QNVh5dShFFvo59N3GlK9N6VPrjS1ZXeu9Ks1rw5Jhc7w_Cn4slMBdgBSPVp2UD82_r_qb8Bu-mgJA</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Arsava, Ethem Murat</creator><creator>Arat, Anil</creator><creator>Topcuoglu, Mehmet Akif</creator><creator>Peker, Ahmet</creator><creator>Yemisci, Muge</creator><creator>Dalkara, Turgay</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6527-4139</orcidid></search><sort><creationdate>20180201</creationdate><title>Angiographic Microcirculatory Obstructions Distal to Occlusion Signify Poor Outcome after Endovascular Treatment for Acute Ischemic Stroke</title><author>Arsava, Ethem Murat ; Arat, Anil ; Topcuoglu, Mehmet Akif ; Peker, Ahmet ; Yemisci, Muge ; Dalkara, Turgay</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-425edd76b7b2e647e093b1b66756bb510b2f87de8349b9d3d5a11757805827f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Blood clots</topic><topic>Cardiology</topic><topic>Clinical outcomes</topic><topic>Ischemia</topic><topic>Medical imaging</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Patients</topic><topic>Stroke</topic><topic>Success</topic><topic>Tomography</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arsava, Ethem Murat</creatorcontrib><creatorcontrib>Arat, Anil</creatorcontrib><creatorcontrib>Topcuoglu, Mehmet Akif</creatorcontrib><creatorcontrib>Peker, Ahmet</creatorcontrib><creatorcontrib>Yemisci, Muge</creatorcontrib><creatorcontrib>Dalkara, Turgay</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>MEDLINE - Academic</collection><jtitle>Translational stroke research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arsava, Ethem Murat</au><au>Arat, Anil</au><au>Topcuoglu, Mehmet Akif</au><au>Peker, Ahmet</au><au>Yemisci, Muge</au><au>Dalkara, Turgay</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Angiographic Microcirculatory Obstructions Distal to Occlusion Signify Poor Outcome after Endovascular Treatment for Acute Ischemic Stroke</atitle><jtitle>Translational stroke research</jtitle><stitle>Transl. Stroke Res</stitle><addtitle>Transl Stroke Res</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>9</volume><issue>1</issue><spage>44</spage><epage>50</epage><pages>44-50</pages><issn>1868-4483</issn><eissn>1868-601X</eissn><abstract>The success of endovascular therapies depends on a number of factors including flow dynamics proximal and distal to the occlusion. The evaluation of antegrade flow distal to the occluded segment is currently a readily available, yet unexplored, option during stentriever-mediated thrombectomy. In this study, we retrospectively evaluated presence of contrast stasis and absence of capillary blush on angiograms obtained by selective injections into the distal site of occlusive thrombi, prior to deployment of stentrievers, in patients undergoing endovascular treatment for acute MCA occlusion. The role of this novel angiographic strategy assessing distal antegrade flow in predicting procedural and clinical outcome was compared to previously defined, prognostic angiographic characteristics. A total of 7 (21%) out of 34 patients had contrast stasis and lack of capillary blush downstream to the injection site. None of these patients with angiographic features suggestive of microcirculatory obstructions achieved a satisfactory outcome in terms of reperfusion (TICI grade 2B–C) and clinical outcome (90-day mRS 0–2), while the corresponding figures were 78% (
p
< 0.001) and 48% (
p
= 0.029), respectively, among patients with substantial capillary filling. These findings highlight the potentially detrimental impact of impaired microcirculatory flow on tissue and clinical outcome after recanalization/reperfusion efforts in acute ischemic stroke.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28825223</pmid><doi>10.1007/s12975-017-0562-2</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-6527-4139</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1868-4483 |
| ispartof | Translational stroke research, 2018-02, Vol.9 (1), p.44-50 |
| issn | 1868-4483 1868-601X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1930933007 |
| source | ProQuest Central (Alumni Edition); ProQuest Central UK/Ireland; SpringerLink Journals - AutoHoldings; ProQuest Central |
| subjects | Biomedical and Life Sciences Biomedicine Blood clots Cardiology Clinical outcomes Ischemia Medical imaging Neurology Neurosciences Neurosurgery Original Article Patients Stroke Success Tomography Vascular Surgery |
| title | Angiographic Microcirculatory Obstructions Distal to Occlusion Signify Poor Outcome after Endovascular Treatment for Acute Ischemic Stroke |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T14%3A24%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Angiographic%20Microcirculatory%20Obstructions%20Distal%20to%20Occlusion%20Signify%20Poor%20Outcome%20after%20Endovascular%20Treatment%20for%20Acute%20Ischemic%20Stroke&rft.jtitle=Translational%20stroke%20research&rft.au=Arsava,%20Ethem%20Murat&rft.date=2018-02-01&rft.volume=9&rft.issue=1&rft.spage=44&rft.epage=50&rft.pages=44-50&rft.issn=1868-4483&rft.eissn=1868-601X&rft_id=info:doi/10.1007/s12975-017-0562-2&rft_dat=%3Cproquest_cross%3E1930933007%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2919508037&rft_id=info:pmid/28825223&rfr_iscdi=true |