Cerebral circulation time on DSA during endovascular treatment in WFNS grade I aneurysmal SAH patients—a predictor of DCI?
Purpose Delayed cerebral ischemia (DCI) remains a contributor to poor outcome following aneurysmal subarachnoid hemorrhage (aSAH). We evaluated cerebral circulation time (CCT) on digital subtraction angiography (DSA) during endovascular treatment (EVT) in WFNS grade I aSAH patients as a predictor of...
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| Veröffentlicht in: | Neuroradiology 2021-12, Vol.63 (12), p.2131-2138 |
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| creator | Schembri, Mark Verbaan, Dagmar Emmer, Bart J. Coert, Bert A. Majoie, Charles B. L. M. Vandertop, W. Peter van den Berg, René |
| description | Purpose
Delayed cerebral ischemia (DCI) remains a contributor to poor outcome following aneurysmal subarachnoid hemorrhage (aSAH). We evaluated cerebral circulation time (CCT) on digital subtraction angiography (DSA) during endovascular treatment (EVT) in WFNS grade I aSAH patients as a predictor of DCI.
Methods
Of 135 consecutive WNFS grade I aSAH patients, 90 were included. Age, gender, time of DSA from ictus ( 72 h), Fisher scale, severe vasospasm, development of DCI, EVD-dependent hydrocephalus, re-bleeding, and procedural complications were recorded. CCT was calculated retrospectively from multiphase DSA. Association with DCI was established through univariate and, subsequently, multivariable logistic regression. An optimal threshold value was identified using ROC curve analysis. Patient groups defined by threshold CCT value, DCI, and, subsequently, time of DSA from ictus were analyzed using χ
2
and Fisher’s exact test.
Results
CCT was the only significant factor in the multivariable logistic regression for the outcome development of DCI (OR/second increase in CCT = 1.46 [95% CI 1.14–1.86,
p
= .003]). When CCT was dichotomized at 8.5 s, the odds ratio for developing DCI was 7.12 (95% CI 1.93–26.34,
p
= .003) for CCT > 8.5 s compared with 8.5 s on DSA during EVT in WFNS grade I aSAH patients is associated with an increased risk of developing DCI and may aid in the management of high-risk patients. |
| doi_str_mv | 10.1007/s00234-021-02749-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2552056534</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2596810571</sourcerecordid><originalsourceid>FETCH-LOGICAL-c418t-e84bcff1ff59267b7d98efdf490726e25a44b61c9efed769848a3c85fe392c3e3</originalsourceid><addsrcrecordid>eNp9kc1qFEEUhQtRcIy-gKsCN27a3Prprq6VDJPEDIS4GMVlUVN9K3Tov9zqDgRc-BB5Qp8kNY4QcOHichb3O4fLPYy9F_BJAJjTBCCVLkCKPEbbAl6wldBKFsJKeMlWeV8Xymp4zd6kdAsAyiizYj83SLgn3_HQUlg6P7fjwOe2R571bLfmzULtcMNxaMZ7nw4I8ZnQzz0OM28H_uPiesdvyDfIt9wPuNBD6nPgbn3Jp5yXsfT716PnE2HThnkkPkZ-ttl-fsteRd8lfPdXT9j3i_Nvm8vi6uuX7WZ9VQQt6rnAWu9DjCLG0srK7E1ja4xN1BaMrFCWXut9JYLFiI2pbK1rr0JdRlRWBoXqhH085k403i2YZte3KWDX5WvHJTlZlhLKqlQ6ox_-QW_HhYZ8XaZsVQsojciUPFKBxpQIo5uo7T09OAHuUIg7FuJyIe5PIQ6ySR1NaTp8FOk5-j-uJ96Ujv0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2596810571</pqid></control><display><type>article</type><title>Cerebral circulation time on DSA during endovascular treatment in WFNS grade I aneurysmal SAH patients—a predictor of DCI?</title><source>SpringerLink Journals - AutoHoldings</source><creator>Schembri, Mark ; Verbaan, Dagmar ; Emmer, Bart J. ; Coert, Bert A. ; Majoie, Charles B. L. M. ; Vandertop, W. Peter ; van den Berg, René</creator><creatorcontrib>Schembri, Mark ; Verbaan, Dagmar ; Emmer, Bart J. ; Coert, Bert A. ; Majoie, Charles B. L. M. ; Vandertop, W. Peter ; van den Berg, René</creatorcontrib><description>Purpose
Delayed cerebral ischemia (DCI) remains a contributor to poor outcome following aneurysmal subarachnoid hemorrhage (aSAH). We evaluated cerebral circulation time (CCT) on digital subtraction angiography (DSA) during endovascular treatment (EVT) in WFNS grade I aSAH patients as a predictor of DCI.
Methods
Of 135 consecutive WNFS grade I aSAH patients, 90 were included. Age, gender, time of DSA from ictus (< 72 h or > 72 h), Fisher scale, severe vasospasm, development of DCI, EVD-dependent hydrocephalus, re-bleeding, and procedural complications were recorded. CCT was calculated retrospectively from multiphase DSA. Association with DCI was established through univariate and, subsequently, multivariable logistic regression. An optimal threshold value was identified using ROC curve analysis. Patient groups defined by threshold CCT value, DCI, and, subsequently, time of DSA from ictus were analyzed using χ
2
and Fisher’s exact test.
Results
CCT was the only significant factor in the multivariable logistic regression for the outcome development of DCI (OR/second increase in CCT = 1.46 [95% CI 1.14–1.86,
p
= .003]). When CCT was dichotomized at 8.5 s, the odds ratio for developing DCI was 7.12 (95% CI 1.93–26.34,
p
= .003) for CCT > 8.5 s compared with < 8.5 s. There was a significant difference for DCI in all patient groups dichotomized by CCT < 8.5 s and > 8.5 s (all patients,
p
= .001; patients imaged before and after 72 h of ictus,
p
= .024 and
p
= .034, respectively).
Conclusion
A CCT > 8.5 s on DSA during EVT in WFNS grade I aSAH patients is associated with an increased risk of developing DCI and may aid in the management of high-risk patients.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-021-02749-0</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aneurysm ; Angiography ; Cardiovascular system ; Cerebral blood flow ; Complications ; Hemorrhage ; Hydrocephalus ; Imaging ; Interventional Neuroradiology ; Ischemia ; Medicine ; Medicine & Public Health ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Patients ; Radiology ; Risk groups ; Risk management ; Subarachnoid hemorrhage ; Vasoconstriction</subject><ispartof>Neuroradiology, 2021-12, Vol.63 (12), p.2131-2138</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-e84bcff1ff59267b7d98efdf490726e25a44b61c9efed769848a3c85fe392c3e3</citedby><cites>FETCH-LOGICAL-c418t-e84bcff1ff59267b7d98efdf490726e25a44b61c9efed769848a3c85fe392c3e3</cites><orcidid>0000-0002-3611-2771</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/s00234-021-02749-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00234-021-02749-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Schembri, Mark</creatorcontrib><creatorcontrib>Verbaan, Dagmar</creatorcontrib><creatorcontrib>Emmer, Bart J.</creatorcontrib><creatorcontrib>Coert, Bert A.</creatorcontrib><creatorcontrib>Majoie, Charles B. L. M.</creatorcontrib><creatorcontrib>Vandertop, W. Peter</creatorcontrib><creatorcontrib>van den Berg, René</creatorcontrib><title>Cerebral circulation time on DSA during endovascular treatment in WFNS grade I aneurysmal SAH patients—a predictor of DCI?</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><description>Purpose
Delayed cerebral ischemia (DCI) remains a contributor to poor outcome following aneurysmal subarachnoid hemorrhage (aSAH). We evaluated cerebral circulation time (CCT) on digital subtraction angiography (DSA) during endovascular treatment (EVT) in WFNS grade I aSAH patients as a predictor of DCI.
Methods
Of 135 consecutive WNFS grade I aSAH patients, 90 were included. Age, gender, time of DSA from ictus (< 72 h or > 72 h), Fisher scale, severe vasospasm, development of DCI, EVD-dependent hydrocephalus, re-bleeding, and procedural complications were recorded. CCT was calculated retrospectively from multiphase DSA. Association with DCI was established through univariate and, subsequently, multivariable logistic regression. An optimal threshold value was identified using ROC curve analysis. Patient groups defined by threshold CCT value, DCI, and, subsequently, time of DSA from ictus were analyzed using χ
2
and Fisher’s exact test.
Results
CCT was the only significant factor in the multivariable logistic regression for the outcome development of DCI (OR/second increase in CCT = 1.46 [95% CI 1.14–1.86,
p
= .003]). When CCT was dichotomized at 8.5 s, the odds ratio for developing DCI was 7.12 (95% CI 1.93–26.34,
p
= .003) for CCT > 8.5 s compared with < 8.5 s. There was a significant difference for DCI in all patient groups dichotomized by CCT < 8.5 s and > 8.5 s (all patients,
p
= .001; patients imaged before and after 72 h of ictus,
p
= .024 and
p
= .034, respectively).
Conclusion
A CCT > 8.5 s on DSA during EVT in WFNS grade I aSAH patients is associated with an increased risk of developing DCI and may aid in the management of high-risk patients.</description><subject>Aneurysm</subject><subject>Angiography</subject><subject>Cardiovascular system</subject><subject>Cerebral blood flow</subject><subject>Complications</subject><subject>Hemorrhage</subject><subject>Hydrocephalus</subject><subject>Imaging</subject><subject>Interventional Neuroradiology</subject><subject>Ischemia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Patients</subject><subject>Radiology</subject><subject>Risk groups</subject><subject>Risk management</subject><subject>Subarachnoid hemorrhage</subject><subject>Vasoconstriction</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kc1qFEEUhQtRcIy-gKsCN27a3Prprq6VDJPEDIS4GMVlUVN9K3Tov9zqDgRc-BB5Qp8kNY4QcOHichb3O4fLPYy9F_BJAJjTBCCVLkCKPEbbAl6wldBKFsJKeMlWeV8Xymp4zd6kdAsAyiizYj83SLgn3_HQUlg6P7fjwOe2R571bLfmzULtcMNxaMZ7nw4I8ZnQzz0OM28H_uPiesdvyDfIt9wPuNBD6nPgbn3Jp5yXsfT716PnE2HThnkkPkZ-ttl-fsteRd8lfPdXT9j3i_Nvm8vi6uuX7WZ9VQQt6rnAWu9DjCLG0srK7E1ja4xN1BaMrFCWXut9JYLFiI2pbK1rr0JdRlRWBoXqhH085k403i2YZte3KWDX5WvHJTlZlhLKqlQ6ox_-QW_HhYZ8XaZsVQsojciUPFKBxpQIo5uo7T09OAHuUIg7FuJyIe5PIQ6ySR1NaTp8FOk5-j-uJ96Ujv0</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Schembri, Mark</creator><creator>Verbaan, Dagmar</creator><creator>Emmer, Bart J.</creator><creator>Coert, Bert A.</creator><creator>Majoie, Charles B. L. M.</creator><creator>Vandertop, W. Peter</creator><creator>van den Berg, René</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3611-2771</orcidid></search><sort><creationdate>20211201</creationdate><title>Cerebral circulation time on DSA during endovascular treatment in WFNS grade I aneurysmal SAH patients—a predictor of DCI?</title><author>Schembri, Mark ; Verbaan, Dagmar ; Emmer, Bart J. ; Coert, Bert A. ; Majoie, Charles B. L. M. ; Vandertop, W. Peter ; van den Berg, René</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-e84bcff1ff59267b7d98efdf490726e25a44b61c9efed769848a3c85fe392c3e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aneurysm</topic><topic>Angiography</topic><topic>Cardiovascular system</topic><topic>Cerebral blood flow</topic><topic>Complications</topic><topic>Hemorrhage</topic><topic>Hydrocephalus</topic><topic>Imaging</topic><topic>Interventional Neuroradiology</topic><topic>Ischemia</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Patients</topic><topic>Radiology</topic><topic>Risk groups</topic><topic>Risk management</topic><topic>Subarachnoid hemorrhage</topic><topic>Vasoconstriction</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schembri, Mark</creatorcontrib><creatorcontrib>Verbaan, Dagmar</creatorcontrib><creatorcontrib>Emmer, Bart J.</creatorcontrib><creatorcontrib>Coert, Bert A.</creatorcontrib><creatorcontrib>Majoie, Charles B. L. M.</creatorcontrib><creatorcontrib>Vandertop, W. Peter</creatorcontrib><creatorcontrib>van den Berg, René</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</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 Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schembri, Mark</au><au>Verbaan, Dagmar</au><au>Emmer, Bart J.</au><au>Coert, Bert A.</au><au>Majoie, Charles B. L. M.</au><au>Vandertop, W. Peter</au><au>van den Berg, René</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral circulation time on DSA during endovascular treatment in WFNS grade I aneurysmal SAH patients—a predictor of DCI?</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><date>2021-12-01</date><risdate>2021</risdate><volume>63</volume><issue>12</issue><spage>2131</spage><epage>2138</epage><pages>2131-2138</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><abstract>Purpose
Delayed cerebral ischemia (DCI) remains a contributor to poor outcome following aneurysmal subarachnoid hemorrhage (aSAH). We evaluated cerebral circulation time (CCT) on digital subtraction angiography (DSA) during endovascular treatment (EVT) in WFNS grade I aSAH patients as a predictor of DCI.
Methods
Of 135 consecutive WNFS grade I aSAH patients, 90 were included. Age, gender, time of DSA from ictus (< 72 h or > 72 h), Fisher scale, severe vasospasm, development of DCI, EVD-dependent hydrocephalus, re-bleeding, and procedural complications were recorded. CCT was calculated retrospectively from multiphase DSA. Association with DCI was established through univariate and, subsequently, multivariable logistic regression. An optimal threshold value was identified using ROC curve analysis. Patient groups defined by threshold CCT value, DCI, and, subsequently, time of DSA from ictus were analyzed using χ
2
and Fisher’s exact test.
Results
CCT was the only significant factor in the multivariable logistic regression for the outcome development of DCI (OR/second increase in CCT = 1.46 [95% CI 1.14–1.86,
p
= .003]). When CCT was dichotomized at 8.5 s, the odds ratio for developing DCI was 7.12 (95% CI 1.93–26.34,
p
= .003) for CCT > 8.5 s compared with < 8.5 s. There was a significant difference for DCI in all patient groups dichotomized by CCT < 8.5 s and > 8.5 s (all patients,
p
= .001; patients imaged before and after 72 h of ictus,
p
= .024 and
p
= .034, respectively).
Conclusion
A CCT > 8.5 s on DSA during EVT in WFNS grade I aSAH patients is associated with an increased risk of developing DCI and may aid in the management of high-risk patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00234-021-02749-0</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3611-2771</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-3940 |
| ispartof | Neuroradiology, 2021-12, Vol.63 (12), p.2131-2138 |
| issn | 0028-3940 1432-1920 |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Aneurysm Angiography Cardiovascular system Cerebral blood flow Complications Hemorrhage Hydrocephalus Imaging Interventional Neuroradiology Ischemia Medicine Medicine & Public Health Neurology Neuroradiology Neurosciences Neurosurgery Patients Radiology Risk groups Risk management Subarachnoid hemorrhage Vasoconstriction |
| title | Cerebral circulation time on DSA during endovascular treatment in WFNS grade I aneurysmal SAH patients—a predictor of DCI? |
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