PMID- 33227529
OWN - NLM
STAT- MEDLINE
DCOM- 20210705
LR  - 20210705
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 146
DP  - 2021 Feb
TI  - Clinical Implications of Preinterventional Thrombus Migration in Patients with 
      Emergent Large Vessel Occlusion.
PG  - e1012-e1020
LID - S1878-8750(20)32455-4 [pii]
LID - 10.1016/j.wneu.2020.11.080 [doi]
AB  - BACKGROUND: In patients treated with thrombectomy, thrombus migration (TM) to 
      distal arterial segments is occasionally observed. We investigated the incidence 
      of TM, factors associated with TM, and association between TM and clinical 
      outcomes. METHODS: The study population consisted of 164 patients with anterior 
      circulation stroke who underwent pretreatment brain computed tomography 
      angiography and digital subtraction angiography before undergoing thrombectomy. 
      TM was defined as a thrombus shift to a more distal arterial segment observed on 
      digital subtraction angiography than that on computed tomography angiography. 
      Successful and complete recanalization was defined as cerebral infarction 
      perfusion scale scores of 2b-3 and 3, respectively. Good functional outcomes were 
      defined as scores of </=2 on the modified Rankin Scale at 3 months. The results are 
      presented as adjusted odds ratios (ORs) and 95% confidence intervals (CIs). 
      RESULTS: Thirty-two patients (19.5%) had TM. Intravenous thrombolysis (IVT) (OR, 
      5.238; 95% CI, 1.653-16.603) and female sex (OR, 2.874; 95% CI, 1.135-7.277) were 
      associated with TM. IVT-related TM was not significantly associated with thrombus 
      inaccessibility (P = 0.304). In addition, TM was not associated with successful 
      (P = 0.960) or complete (P = 0.612) recanalization. However, TM (OR, 2.777; 95% 
      CI, 1.019-7.569), together with IVT (OR, 2.982; 95% CI, 1.332-6.676), a low 
      National Institutes of Health Stroke Scale score (OR, 0.906; 95% CI, 
      0.845-0.972), and successful recanalization (OR, 4.878; 95% CI, 1.940-12.266), 
      were independently associated with good functional outcomes. CONCLUSIONS: TM is 
      common, particularly after IVT. In addition, TM is associated with better 
      functional outcomes, irrespective of the angiographic outcomes.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Lee, Seung-Jae
AU  - Lee SJ
AD  - Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, 
      South Korea. Electronic address: neurosj@catholic.ac.kr.
FAU - Lee, Tae-Kyeong
AU  - Lee TK
AD  - Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, 
      South Korea.
FAU - Kim, Bum-Tae
AU  - Kim BT
AD  - Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, 
      South Korea.
FAU - Shin, Dong-Seong
AU  - Shin DS
AD  - Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, 
      South Korea.
LA  - eng
PT  - Journal Article
DEP - 20201121
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
SB  - IM
CIN - World Neurosurg. 2021 Mar;147:246. PMID: 33685019
CIN - World Neurosurg. 2021 Mar;147:247. PMID: 33685020
MH  - Administration, Intravenous
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiography, Digital Subtraction
MH  - Cerebral Angiography
MH  - Computed Tomography Angiography
MH  - Disease Progression
MH  - Endovascular Procedures
MH  - Female
MH  - Humans
MH  - Intracranial Thrombosis/diagnostic imaging/physiopathology/*surgery
MH  - Ischemic Stroke/diagnostic imaging/physiopathology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Preoperative Period
MH  - Risk Factors
MH  - Sex Factors
MH  - *Thrombectomy
MH  - Thrombolytic Therapy/*statistics & numerical data
OTO - NOTNLM
OT  - Stroke
OT  - Thrombectomy
OT  - Thrombus
OT  - Tissue plasminogen activator
EDAT- 2020/11/24 06:00
MHDA- 2021/07/06 06:00
CRDT- 2020/11/23 20:10
PHST- 2020/09/23 00:00 [received]
PHST- 2020/11/11 00:00 [revised]
PHST- 2020/11/12 00:00 [accepted]
PHST- 2020/11/24 06:00 [pubmed]
PHST- 2021/07/06 06:00 [medline]
PHST- 2020/11/23 20:10 [entrez]
AID - S1878-8750(20)32455-4 [pii]
AID - 10.1016/j.wneu.2020.11.080 [doi]
PST - ppublish
SO  - World Neurosurg. 2021 Feb;146:e1012-e1020. doi: 10.1016/j.wneu.2020.11.080. Epub 
      2020 Nov 21.