Spiotta Alejandro M, Vargas Jan, Hawk Harris, Turner Raymond, Chaudry M Imran, Battenhouse Holly, Turk Aquilla S
Division of Neurosurgery, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA Department of Interventional Neuroradiology, Medical University of South Carolina, Charleston, South Carolina, USA.
Division of Neurosurgery, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA.
J Neurointerv Surg. 2014 Jul;6(6):423-7. doi: 10.1136/neurintsurg-2013-010765. Epub 2013 Jul 31.
Intra-arterial therapy for acute ischemic stroke (AIS) now has an established role. We investigated if Hounsfield Units (HU) quantification on non-contrast CT is associated with ease and efficacy of mechanical thrombectomy and outcomes.
We retrospectively studied a prospectively maintained database of cases of AIS given intra-arterial therapy between May 2008 and August 2012. Functional outcome was assessed by 90-day follow-up modified Rankin Scale (mRS). Patients were dichotomized based on time to recanalization. HU were calculated on head CT and thrombus location and length were determined on CT angiography. Simple linear regression was used to analyze the association between clot length, average HU and other clinical variables.
141 patients were included. There was no difference in clot length or average HU among patients with good recanalization achieved within 1 h and those in which the procedures extended beyond 1 h. There was no relationship between clot length or density and recanalization. The thrombus length and density were not significantly different between patients with procedural complications and those without. Neither the presence of post-procedure intracranial hemorrhage nor the 90-day mRS was associated with thrombus length or density.
We have not found any significant associations between either thrombus length or density and likelihood of recanalization, time to achieve recanalization, intraprocedural complications, postprocedural hemorrhage or functional outcome at 90 days. These results do not support a predictive value for thrombus quantification in the evaluation of AIS.
动脉内治疗急性缺血性卒中（AIS）目前已确立其作用。我们研究了非增强CT上的亨氏单位（HU）定量是否与机械取栓的难易程度、疗效及预后相关。
我们回顾性研究了一个前瞻性维护的数据库，该数据库包含2008年5月至2012年8月接受动脉内治疗的AIS病例。通过90天随访改良Rankin量表（mRS）评估功能预后。根据再通时间将患者分为两组。在头部CT上计算HU，并在CT血管造影上确定血栓位置和长度。采用简单线性回归分析血栓长度、平均HU与其他临床变量之间的关联。
纳入141例患者。在1小时内实现良好再通的患者与手术时间超过1小时的患者之间，血栓长度或平均HU没有差异。血栓长度或密度与再通之间没有关系。发生手术并发症的患者与未发生并发症的患者之间，血栓长度和密度没有显著差异。术后颅内出血的发生情况和90天mRS均与血栓长度或密度无关。
我们未发现血栓长度或密度与再通可能性、实现再通的时间、术中并发症、术后出血或90天功能预后之间存在任何显著关联。这些结果不支持在AIS评估中对血栓定量的预测价值。
