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Prediction of Early Recanalization after Intravenous Thrombolysis in Patients with Large-Vessel Occlusion
- Title
- Prediction of Early Recanalization after Intravenous Thrombolysis in Patients with Large-Vessel Occlusion
- Authors
- Kim, Young Dae; Nam, Hyo Suk; Yoo, Joonsang; Park, Hyungjong; Sohn, Sung-Il; Hong, Jeong-Ho; Kim, Byung Moon; Kim, Dong Joon; Bang, Oh Young; Seo, Woo-Keun; Chung, Jong-Won; Lee, Kyung-Yul; Jung, Yo Han; Lee, Hye Sun; Ahn, Seong Hwan; Shin, Dong Hoon; Choi, Hye-Yeon; Cho, Han-Jin; Baek, Jang-Hyun; Kim, Gyu Sik; Seo, Kwon-Duk; Kim, Seo Hyun; Song, Tae-Jin; Kim, Jinkwon; Han, Sang Won; Park, Joong Hyun; Lee, Sung Ik; Heo, JoonNyung; Choi, Jin Kyo; Heo, Ji Hoe|Thrombus Imaging Study Grp; SECRET Study Grp
- Ewha Authors
- 송태진
- SCOPUS Author ID
- 송태진
- Issue Date
- 2021
- Journal Title
- JOURNAL OF STROKE
- ISSN
- 2287-6391
2287-6405
- Citation
- JOURNAL OF STROKE vol. 23, no. 2, pp. 244 - +
- Keywords
- Ischemia; Stroke; Thrombosis; Thrombolysis; Reperfusion
- Publisher
- KOREAN STROKE SOC
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background and Purpose We aimed to develop a model predicting early recanalization after in-travenous tissue plasminogen activator (t-PA) treatment in large-vessel occlusion. Methods Using data from two different multicenter prospective cohorts, we determined the fac-tors associated with early recanalization immediately after t-PA in stroke patients with large-ves-sel occlusion, and developed and validated a prediction model for early recanalization. Clot volume was semiautomatically measured on thin-section computed tomography using software, and the degree of collaterals was determined using the Tan score. Follow-up angiographic studies were performed immediately after t-PA treatment to assess early recanalization. Results Early recanalization, assessed 61.0 +/- 44.7 minutes after t-PA bolus, was achieved in 15.5% (15/97) in the derivation cohort and in 10.5% (8/76) in the validation cohort. Clot volume (odds ratio [OR], 0.979; 95% confidence interval [CI], 0.961 to 0.997; P=0.020) and good collaterals (OR, 6.129; 95% CI, 1.592 to 23.594; P=0.008) were significant factors associated with early recanalization. The area under the curve (AUC) of the model including clot volume was 0.819 (95% CI, 0.720 to 0.917) and 0.842 (95% CI, 0.746 to 0.938) in the derivation and validation cohorts, respectively. The AUC improved when good collaterals were added (derivation cohort: AUC, 0.876; 95% CI, 0.802 to 0.950; P=0.164; validation cohort: AUC, 0.949; 95% CI, 0.886 to 1.000; P=0.036). The integrated discrimination improvement also showed significantly improved prediction (0.097; 95% CI, 0.009 to 0.185; P=0.032). Conclusions The model using clot volume and collaterals predicted early recanalization after intravenous t-PA and had a high performance. This model may aid in determining the recanalization treatment strategy in stroke patients with large-vessel occlusion.
- DOI
- 10.5853//jos.2020.03622
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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