Derivation and validation of a predictive scale to expedite endovascular intervention for acute stroke patients with an intervenable vessel occlusion.

stroke thrombectomy

Journal

Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079

Informations de publication

Date de publication:
21 Sep 2023
Historique:
received: 31 07 2023
accepted: 27 08 2023
medline: 22 9 2023
pubmed: 22 9 2023
entrez: 21 9 2023
Statut: aheadofprint

Résumé

Early endovascular intervention team mobilization may reduce reperfusion times and improve clinical outcomes for patients with acute ischemic stroke (AIS) with a possible intervenable vessel occlusion (IVO). In an emergency department or mobile stroke unit, incorporating rapidly available non-contrast CT (NCCT) information with examination findings may improve the accuracy of arterial occlusion prediction scales. For this purpose, we developed a rapid and straightforward IVO predictive instrument-the T The T 574 eligible patients from 2115 acute stroke alerts were identified. The scale was established with five items (CT hyperdense sign, parenchymal hypodensity, lateralizing hemiparesis, gaze deviation, and language disturbance), with a total score of 9. To minimize unnecessary angiography, a cut-off of ≥5 for IVO detection yielded a sensitivity of 52%, a specificity of 90%, and a positive predictive value of 76%. The T

Sections du résumé

BACKGROUND BACKGROUND
Early endovascular intervention team mobilization may reduce reperfusion times and improve clinical outcomes for patients with acute ischemic stroke (AIS) with a possible intervenable vessel occlusion (IVO). In an emergency department or mobile stroke unit, incorporating rapidly available non-contrast CT (NCCT) information with examination findings may improve the accuracy of arterial occlusion prediction scales. For this purpose, we developed a rapid and straightforward IVO predictive instrument-the T
METHODS METHODS
The T
RESULTS RESULTS
574 eligible patients from 2115 acute stroke alerts were identified. The scale was established with five items (CT hyperdense sign, parenchymal hypodensity, lateralizing hemiparesis, gaze deviation, and language disturbance), with a total score of 9. To minimize unnecessary angiography, a cut-off of ≥5 for IVO detection yielded a sensitivity of 52%, a specificity of 90%, and a positive predictive value of 76%.
CONCLUSIONS CONCLUSIONS
The T

Identifiants

pubmed: 37734930
pii: jnis-2023-020871
doi: 10.1136/jnis-2023-020871
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: WSB has received grants from Athersys, BMS, Florida High Tech Corridor, NIH, Reneuron, and VuEssence. His consulting activities include Genentech, VuEssence, with stock options in VuEssence. He has patents planned or pending with USF. His equity positions include holdings in Inur Technologies and Electron Transport Biotech. He also has a financial interest in PRIME Education. MM has received grants from the NIH and has consulted with Balt, Cerenovus, Medtronic, and Rapid Pulse. His testimony work includes Foley Mansfield and Huff Powell Bailey as clients. He has participated as an advisor for Cerenovus and Rapid Pulse. His financial holdings include Bendit Technologies, Borvo Medical, BrainQ, Endostream, Serenity Medical, Synchron, Sim & Cure, QAS AI, Quantanosis AI. ZR has received royalties for his publication on aneurysms and has lectured for Beijing Tiantan Hospital, the Chinese Stroke Association, and the Chinese Institute for Brain Research.

Auteurs

Zeguang Ren (Z)

Department of Neurosurgery, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China wburgin@usf.edu renzem@gmail.com.

Runqi Wangqin (R)

Duke Clinical Research Institute, Duke Univeristy Medical Center, Durham, North Carolina, USA.

Francis Demiraj (F)

Department of Neurology, FAU Schmidt College of Medicine, Boca Raton, Florida, USA.

Weizhe Li (W)

Department of Neurology, Duke University, Durham, North Carolina, USA.

Maxim Mokin (M)

Department of Neurosurgery and Neurology, University of South Florida, Tampa, Florida, USA.

Anxin Wang (A)

China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.

Zhongrong Miao (Z)

Department of Neurological Intervention, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Yongjun Wang (Y)

China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, China.

W Scott Burgin (WS)

Department of Neurology, University of South Florida, Tampa, Florida, USA wburgin@usf.edu renzem@gmail.com.

Classifications MeSH