A Simple Geometric Assessment of Perfusion Lesion Volume at Hyperacute Stage of Ischemic Stroke in Patients with Symptomatic Steno-Occlusion of Major Cerebral Arteries and Risk of Subsequent Cerebral Ischemic Events

Jihoon Kang, Cheolkyu Jung, Nayoung Kim, Yoo Ri Son, Byungse Choi, Jae Hyoung Kim, Ji Sung Lee, Jun Lee, Myung Suk Jang, Mi Hwa Yang, Moon Ku Han, Hee Joon Bae, Juneyoung Lee

Research output: Contribution to journalArticle

Abstract

Our objective is to elucidate the association of baseline perfusion lesion volume on perfusion-weighted magnetic resonance imaging (PWI) obtained at hyperacute stage of ischemic stroke with subsequent cerebral ischemic events (SIEs) in patients with symptomatic steno-occlusion of major cerebral arteries. Using a prospective stroke registry database, patients arriving within 24 hours of onset with symptomatic steno-occlusion of major supratentorial cerebral arteries were identified. On baseline PWI, time-to-peak lesion volume (TTP-LV) was determined by a simple geometric method and dichotomized into the highest tertile (large) and the other tertiles (small to medium) according to the vascular territory of occluded arteries. Primary outcome was a time to SIE up to 1 year after stroke onset. A total of 385 patients (a median time delay from onset to arrival, 2.2 hours) were enrolled. During the first year of stroke, the SIE rate of the large TTP-LV group was twice that of the small-to-medium TTP-LV group (35.7% versus 17.4%; P <.001). Large TTP-LV independently raised the hazard of SIE (hazard ratio, 2.24; 95% confidence interval, 1.45-3.44). This study demonstrates that TTP-LV on PWI measured through a simple geometric method at an emergency setting can be used to predict progression or recurrence of ischemic stroke in patients with symptomatic steno-occlusion of major cerebral arteries.

Original languageEnglish
Pages (from-to)2669-2675
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume24
Issue number12
DOIs
Publication statusPublished - 2015 Dec 1

Fingerprint

Cerebral Arteries
Perfusion
Stroke
Magnetic Resonance Angiography
Blood Vessels
Registries
Emergencies
Arteries
Databases
Confidence Intervals
Recurrence

Keywords

  • Cerebral ischemia
  • perfusion
  • progression
  • recurrence
  • stenosis and cerebrovascular occlusion

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

A Simple Geometric Assessment of Perfusion Lesion Volume at Hyperacute Stage of Ischemic Stroke in Patients with Symptomatic Steno-Occlusion of Major Cerebral Arteries and Risk of Subsequent Cerebral Ischemic Events. / Kang, Jihoon; Jung, Cheolkyu; Kim, Nayoung; Son, Yoo Ri; Choi, Byungse; Kim, Jae Hyoung; Lee, Ji Sung; Lee, Jun; Jang, Myung Suk; Yang, Mi Hwa; Han, Moon Ku; Bae, Hee Joon; Lee, Juneyoung.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 24, No. 12, 01.12.2015, p. 2669-2675.

Research output: Contribution to journalArticle

Kang, Jihoon ; Jung, Cheolkyu ; Kim, Nayoung ; Son, Yoo Ri ; Choi, Byungse ; Kim, Jae Hyoung ; Lee, Ji Sung ; Lee, Jun ; Jang, Myung Suk ; Yang, Mi Hwa ; Han, Moon Ku ; Bae, Hee Joon ; Lee, Juneyoung. / A Simple Geometric Assessment of Perfusion Lesion Volume at Hyperacute Stage of Ischemic Stroke in Patients with Symptomatic Steno-Occlusion of Major Cerebral Arteries and Risk of Subsequent Cerebral Ischemic Events. In: Journal of Stroke and Cerebrovascular Diseases. 2015 ; Vol. 24, No. 12. pp. 2669-2675.
@article{97cb3af2514248d597f291ae9ce45bc4,
title = "A Simple Geometric Assessment of Perfusion Lesion Volume at Hyperacute Stage of Ischemic Stroke in Patients with Symptomatic Steno-Occlusion of Major Cerebral Arteries and Risk of Subsequent Cerebral Ischemic Events",
abstract = "Our objective is to elucidate the association of baseline perfusion lesion volume on perfusion-weighted magnetic resonance imaging (PWI) obtained at hyperacute stage of ischemic stroke with subsequent cerebral ischemic events (SIEs) in patients with symptomatic steno-occlusion of major cerebral arteries. Using a prospective stroke registry database, patients arriving within 24 hours of onset with symptomatic steno-occlusion of major supratentorial cerebral arteries were identified. On baseline PWI, time-to-peak lesion volume (TTP-LV) was determined by a simple geometric method and dichotomized into the highest tertile (large) and the other tertiles (small to medium) according to the vascular territory of occluded arteries. Primary outcome was a time to SIE up to 1 year after stroke onset. A total of 385 patients (a median time delay from onset to arrival, 2.2 hours) were enrolled. During the first year of stroke, the SIE rate of the large TTP-LV group was twice that of the small-to-medium TTP-LV group (35.7{\%} versus 17.4{\%}; P <.001). Large TTP-LV independently raised the hazard of SIE (hazard ratio, 2.24; 95{\%} confidence interval, 1.45-3.44). This study demonstrates that TTP-LV on PWI measured through a simple geometric method at an emergency setting can be used to predict progression or recurrence of ischemic stroke in patients with symptomatic steno-occlusion of major cerebral arteries.",
keywords = "Cerebral ischemia, perfusion, progression, recurrence, stenosis and cerebrovascular occlusion",
author = "Jihoon Kang and Cheolkyu Jung and Nayoung Kim and Son, {Yoo Ri} and Byungse Choi and Kim, {Jae Hyoung} and Lee, {Ji Sung} and Jun Lee and Jang, {Myung Suk} and Yang, {Mi Hwa} and Han, {Moon Ku} and Bae, {Hee Joon} and Juneyoung Lee",
year = "2015",
month = "12",
day = "1",
doi = "10.1016/j.jstrokecerebrovasdis.2015.05.025",
language = "English",
volume = "24",
pages = "2669--2675",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",
number = "12",

}

TY - JOUR

T1 - A Simple Geometric Assessment of Perfusion Lesion Volume at Hyperacute Stage of Ischemic Stroke in Patients with Symptomatic Steno-Occlusion of Major Cerebral Arteries and Risk of Subsequent Cerebral Ischemic Events

AU - Kang, Jihoon

AU - Jung, Cheolkyu

AU - Kim, Nayoung

AU - Son, Yoo Ri

AU - Choi, Byungse

AU - Kim, Jae Hyoung

AU - Lee, Ji Sung

AU - Lee, Jun

AU - Jang, Myung Suk

AU - Yang, Mi Hwa

AU - Han, Moon Ku

AU - Bae, Hee Joon

AU - Lee, Juneyoung

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Our objective is to elucidate the association of baseline perfusion lesion volume on perfusion-weighted magnetic resonance imaging (PWI) obtained at hyperacute stage of ischemic stroke with subsequent cerebral ischemic events (SIEs) in patients with symptomatic steno-occlusion of major cerebral arteries. Using a prospective stroke registry database, patients arriving within 24 hours of onset with symptomatic steno-occlusion of major supratentorial cerebral arteries were identified. On baseline PWI, time-to-peak lesion volume (TTP-LV) was determined by a simple geometric method and dichotomized into the highest tertile (large) and the other tertiles (small to medium) according to the vascular territory of occluded arteries. Primary outcome was a time to SIE up to 1 year after stroke onset. A total of 385 patients (a median time delay from onset to arrival, 2.2 hours) were enrolled. During the first year of stroke, the SIE rate of the large TTP-LV group was twice that of the small-to-medium TTP-LV group (35.7% versus 17.4%; P <.001). Large TTP-LV independently raised the hazard of SIE (hazard ratio, 2.24; 95% confidence interval, 1.45-3.44). This study demonstrates that TTP-LV on PWI measured through a simple geometric method at an emergency setting can be used to predict progression or recurrence of ischemic stroke in patients with symptomatic steno-occlusion of major cerebral arteries.

AB - Our objective is to elucidate the association of baseline perfusion lesion volume on perfusion-weighted magnetic resonance imaging (PWI) obtained at hyperacute stage of ischemic stroke with subsequent cerebral ischemic events (SIEs) in patients with symptomatic steno-occlusion of major cerebral arteries. Using a prospective stroke registry database, patients arriving within 24 hours of onset with symptomatic steno-occlusion of major supratentorial cerebral arteries were identified. On baseline PWI, time-to-peak lesion volume (TTP-LV) was determined by a simple geometric method and dichotomized into the highest tertile (large) and the other tertiles (small to medium) according to the vascular territory of occluded arteries. Primary outcome was a time to SIE up to 1 year after stroke onset. A total of 385 patients (a median time delay from onset to arrival, 2.2 hours) were enrolled. During the first year of stroke, the SIE rate of the large TTP-LV group was twice that of the small-to-medium TTP-LV group (35.7% versus 17.4%; P <.001). Large TTP-LV independently raised the hazard of SIE (hazard ratio, 2.24; 95% confidence interval, 1.45-3.44). This study demonstrates that TTP-LV on PWI measured through a simple geometric method at an emergency setting can be used to predict progression or recurrence of ischemic stroke in patients with symptomatic steno-occlusion of major cerebral arteries.

KW - Cerebral ischemia

KW - perfusion

KW - progression

KW - recurrence

KW - stenosis and cerebrovascular occlusion

UR - http://www.scopus.com/inward/record.url?scp=84949663934&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84949663934&partnerID=8YFLogxK

U2 - 10.1016/j.jstrokecerebrovasdis.2015.05.025

DO - 10.1016/j.jstrokecerebrovasdis.2015.05.025

M3 - Article

C2 - 26476587

AN - SCOPUS:84949663934

VL - 24

SP - 2669

EP - 2675

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

IS - 12

ER -