Early plasma D-dimer as a predictor of acute intracranial atherosclerosis-related large vessel occlusion in acute ischemic stroke.
D-dimer
Stroke
atherosclerosis
collateral circulation
thrombectomy
Journal
Acta radiologica (Stockholm, Sweden : 1987)
ISSN: 1600-0455
Titre abrégé: Acta Radiol
Pays: England
ID NLM: 8706123
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
pubmed:
17
5
2022
medline:
22
3
2023
entrez:
16
5
2022
Statut:
ppublish
Résumé
Intracranial atherosclerosis-related large vessel occlusion (ICAS+LVO) poses an important technical challenge for endovascular thrombectomy (EVT). To evaluate the value of D-dimer in predicting ICAS+LVO alone and in combination with other clinical and imaging predictors. Consecutive patients who underwent EVT at our center between January 2018 and June 2021 were retrospectively reviewed. Patients were classified to the ICAS+LVO or ICAS-LVO group according to angiographic findings. Collateral gradings were evaluated based on computed tomography angiography and categorized as follows: score 0-1 unfavorable collaterals and score 2-3 favorable collaterals. Receiver operating characteristic curve was analyzed to evaluate the predictive value of D-dimer and the combination of other predictors for ICAS+LVO. A total of 374 patients were enrolled, among them, 107 (28.6%) had an ICAS+LVO, while ICAS-LVO was determined in 267 (71.4%) patients. Median D-dimer levels were lower (0.36 vs. 1.18 mg/L; Low early plasma D-dimer levels are a significant and independent predictor of ICAS+LVO, and predictive value strengthens when in a combined model using D-dimer and collateral grading.
Sections du résumé
BACKGROUND
BACKGROUND
Intracranial atherosclerosis-related large vessel occlusion (ICAS+LVO) poses an important technical challenge for endovascular thrombectomy (EVT).
PURPOSE
OBJECTIVE
To evaluate the value of D-dimer in predicting ICAS+LVO alone and in combination with other clinical and imaging predictors.
MATERIAL AND METHODS
METHODS
Consecutive patients who underwent EVT at our center between January 2018 and June 2021 were retrospectively reviewed. Patients were classified to the ICAS+LVO or ICAS-LVO group according to angiographic findings. Collateral gradings were evaluated based on computed tomography angiography and categorized as follows: score 0-1 unfavorable collaterals and score 2-3 favorable collaterals. Receiver operating characteristic curve was analyzed to evaluate the predictive value of D-dimer and the combination of other predictors for ICAS+LVO.
RESULTS
RESULTS
A total of 374 patients were enrolled, among them, 107 (28.6%) had an ICAS+LVO, while ICAS-LVO was determined in 267 (71.4%) patients. Median D-dimer levels were lower (0.36 vs. 1.18 mg/L;
CONCLUSION
CONCLUSIONS
Low early plasma D-dimer levels are a significant and independent predictor of ICAS+LVO, and predictive value strengthens when in a combined model using D-dimer and collateral grading.
Identifiants
pubmed: 35575229
doi: 10.1177/02841851221097463
doi:
Substances chimiques
fibrin fragment D
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM