Blood Oxygenation Level-Dependent Cerebrovascular Reactivity-Derived Steal Phenomenon May Indicate Tissue Reperfusion Failure After Successful Endovascular Thrombectomy.

BOLD-CVR Cerebrovascular reactivity DWI Endovascular thrombectomy Ischemic stroke Large-vessel occlusion Reperfusion failure Steal phenomenon

Journal

Translational stroke research
ISSN: 1868-601X
Titre abrégé: Transl Stroke Res
Pays: United States
ID NLM: 101517297

Informations de publication

Date de publication:
25 Oct 2023
Historique:
received: 01 06 2023
accepted: 17 10 2023
revised: 25 09 2023
medline: 26 10 2023
pubmed: 26 10 2023
entrez: 25 10 2023
Statut: aheadofprint

Résumé

In acute ischemic stroke due to large-vessel occlusion (LVO), the clinical outcome after endovascular thrombectomy (EVT) is influenced by the extent of autoregulatory hemodynamic impairment, which can be derived from blood oxygenation level-dependent cerebrovascular reactivity (BOLD-CVR). BOLD-CVR imaging identifies brain areas influenced by hemodynamic steal. We sought to investigate the presence of steal phenomenon and its relationship to DWI lesions and clinical deficit in the acute phase of ischemic stroke following successful vessel recanalization.From the prospective longitudinal IMPreST (Interplay of Microcirculation and Plasticity after ischemic Stroke) cohort study, patients with acute ischemic unilateral LVO stroke of the anterior circulation with successful endovascular thrombectomy (EVT; mTICI scale ≥ 2b) and subsequent BOLD-CVR examination were included for this analysis. We analyzed the spatial correlation between brain areas exhibiting BOLD-CVR-associated steal phenomenon and DWI infarct lesion as well as the relationship between steal phenomenon and NIHSS score at hospital discharge.Included patients (n = 21) exhibited steal phenomenon to different extents, whereas there was only a partial spatial overlap with the DWI lesion (median 19%; IQR, 8-59). The volume of steal phenomenon outside the DWI lesion showed a positive correlation with overall DWI lesion volume and was a significant predictor for the NIHSS score at hospital discharge.Patients with acute ischemic unilateral LVO stroke exhibited hemodynamic steal identified by BOLD-CVR after successful EVT. Steal volume was associated with DWI infarct lesion size and with poor clinical outcome at hospital discharge. BOLD-CVR may further aid in better understanding persisting hemodynamic impairment following reperfusion therapy.

Identifiants

DOI: 10.1007/s12975-023-01203-y PMID: 37880561
pubmed: 37880561
doi: 10.1007/s12975-023-01203-y
pii: 10.1007/s12975-023-01203-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s).

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Auteurs

Jacopo Bellomo (J)

Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091, Zurich, Switzerland. jacopo.bellomo@usz.ch.
Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland. jacopo.bellomo@usz.ch.

Martina Sebök (M)

Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091, Zurich, Switzerland.
Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.

Vittorio Stumpo (V)

Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091, Zurich, Switzerland.
Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.

Christiaan H B van Niftrik (CHB)

Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091, Zurich, Switzerland.
Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.

Darja Meisterhans (D)

Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091, Zurich, Switzerland.
Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.

Marco Piccirelli (M)

Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Lars Michels (L)

Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Beno Reolon (B)

Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Giuseppe Esposito (G)

Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091, Zurich, Switzerland.
Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.

Tilman Schubert (T)

Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Zsolt Kulcsar (Z)

Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Andreas R Luft (AR)

Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
Cereneo Center for Neurology and Rehabilitation, Vitznau, Switzerland.

Susanne Wegener (S)

Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Department of Neurology, University Hospital Zurich, Zurich, Switzerland.

Luca Regli (L)

Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091, Zurich, Switzerland.
Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.

Jorn Fierstra (J)

Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091, Zurich, Switzerland.
Clinical Neuroscience Center, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.

Classifications MeSH