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影响接受机械取栓治疗的急性卒中患者血管征易感性的因素。

Factors That Influence Susceptibility Vessel Sign in Patients With Acute Stroke Referred for Mechanical Thrombectomy.

作者信息

Dillmann Manon, Bonnet Louise, Vuillier Fabrice, Moulin Thierry, Biondi Alessandra, Charbonnier Guillaume

机构信息

Neurology Department, University Hospital Centre Besancon, Besançon, France.

Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR 481, Université de Franche-Comte UFR Sciences Médicales et Pharmaceutiques, Besançon, France.

出版信息

Front Neurol. 2022 May 11;13:893060. doi: 10.3389/fneur.2022.893060. eCollection 2022.

Abstract

BACKGROUND AND PURPOSE

The presence of a Susceptibility Vessel Sign (SVS) in the acute phase of proximal occlusion ischemic stroke indicates the presence of deoxyhemoglobin in the thrombus. Thrombi composition changes over time. The aim of this study was to investigate whether the absence of SVS is associated with a shorter symptom onset to imaging time.

METHODS

We retrospectively analyzed all patients referred for mechanical thrombectomy at Besançon University Hospital between 1 January 2015 and 31 December 2020 for whom readable T2-weighted imaging was available. We compared patient characteristics according to the presence or absence of an SVS. We also studied the subgroup for whom the exact symptom onset time was known. We performed a univariate statistical analysis, then a multivariate analysis on the variables that were statistically significant in the univariate analysis.

RESULTS

Of the 389 patients included, 309 (79.4%) were SVS+. We found no significant relationship between SVS- and the time between symptom onset and imaging in the whole cohort. In the multivariate analysis, SVS- was associated with anticoagulant treatment ( < 0.01), and SVS+ with age ( = 0.023) and carotid terminus occlusion ( = 0.042). In the known symptom onset subgroup, SVS- was significantly associated with a shorter symptom onset -imaging time ( < 0.001), and this was confirmed in the multivariate analysis ( = 0.011; OR 0.911; 95% CI [0.844; 0.972]).

CONCLUSION

In the acute phase of proximal occlusion ischemic stroke, absence of SVS was associated with a shorter symptom onset-imaging time for patients with a known symptom onset time.

摘要

背景与目的

近端闭塞性缺血性卒中急性期出现的易损血管征(SVS)提示血栓中存在脱氧血红蛋白。血栓成分会随时间变化。本研究的目的是调查无SVS是否与症状发作至影像学检查的时间较短有关。

方法

我们回顾性分析了2015年1月1日至2020年12月31日期间在贝桑松大学医院因机械取栓而就诊且有可读T2加权成像的所有患者。我们根据有无SVS比较了患者特征。我们还研究了症状确切发作时间已知的亚组。我们进行了单变量统计分析,然后对单变量分析中有统计学意义的变量进行了多变量分析。

结果

在纳入的389例患者中,309例(79.4%)为SVS阳性。在整个队列中,我们未发现SVS阴性与症状发作至影像学检查时间之间存在显著关系。在多变量分析中,SVS阴性与抗凝治疗相关(<0.01),SVS阳性与年龄(=0.023)和颈动脉末端闭塞(=0.042)相关。在已知症状发作的亚组中,SVS阴性与较短的症状发作至影像学检查时间显著相关(<0.001),多变量分析证实了这一点(=0.011;OR 0.911;95%CI[0.844;0.972])。

结论

在近端闭塞性缺血性卒中急性期,对于症状发作时间已知的患者,无SVS与较短的症状发作至影像学检查时间相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dea/9130602/43797b6851ce/fneur-13-893060-g0001.jpg

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