医学
冲程(发动机)
白质疏松症
脑出血
蛛网膜下腔出血
心脏病学
缺血性中风
内科学
外科
白质
血肿
改良兰金量表
磁共振成像
放射科
缺血
机械工程
工程类
作者
Zhong‐Song Shi,Yince Loh,David S. Liebeskind,Jeffrey L. Saver,Nestor R. Gonzalez,Satoshi Tateshima,Reza Jahan,Lei Feng,Paul Vespa,Sidney Starkman,Noriko Salamon,J. Pablo Villablance,Latisha K Ali,Bruce Ovbiagele,Doojin Kim,Fernando Viñuela,Gary Duckwiler
出处
期刊:Stroke
[Ovid Technologies (Wolters Kluwer)]
日期:2012-07-01
卷期号:43 (7): 1806-1811
被引量:77
标识
DOI:10.1161/strokeaha.111.649152
摘要
Background and Purpose— The purpose of this study was to determine whether leukoaraiosis (LA) predicts hemorrhagic transformation and poor outcome in patients with acute ischemic stroke treated by mechanical thrombectomy. Methods— We retrospectively analyzed patients with anterior circulation stroke treated with Merci devices and identified LA in the deep white matter (DWM) and periventricular white matter on the preintervention MR images. We dichotomized patients into those with moderate or severe LA in the DWM versus those without. Hemorrhage rates and outcomes were evaluated between 2 groups. We analyzed the association of moderate or severe LA with hemorrhagic transformation and poor outcome. Results— Twenty-six of 105 patients had moderate or severe LA in the DWM. Patients with moderate or severe LA in the DWM were older, had more severe neurological deficits and worse outcome, had higher rates of hemorrhagic transformation and parenchymal hematoma, but had equivalent rates of hemorrhagic infarct and subarachnoid hemorrhage when compared with those without. Patients with only periventricular LA did not have a higher rate of parenchymal hematoma. Moderate or severe LA in the DWM was an independent predictor of hemorrhagic transformation (OR, 3.4; P =0.019) and parenchymal hematoma (OR, 6.3; P =0.005). Patients with parenchymal hematoma were less often independent (modified Rankin Scale ≤2, 3.8% versus 32.5%; P =0.003) and had greater in-hospital mortality (50% versus 10.4%; P <0.001). Conclusions— Moderate or severe LA in the DWM increases the risk of parenchymal hematoma after Merci thrombectomy for patients with acute stroke. These findings require validation in a larger prospective study.
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