Abstract TMP90: The Harm Sign As A Trial Biomarker Of Reperfusion Injury: Frequency, Determinants, And Outcomes In EVT Patients With Successful Reperfusion
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Le résumé fourni par la source
Introduction: With successful reperfusion (SR, mTICI 2b-3) now being achieved in the great preponderance of patients undergoing endovascular thrombectomy (EVT), prevention of blood-brain barrier disruption and reperfusion injury is an emerging therapeutic target. For trials of agents to reduce BBB injury, the hyperintense acute reperfusion marker (HARM) sign is a potentially useful physiologic biomarker. However, past studies of HARM have generally failed to disaggregate non-EVT patients, EVT patients without SR, and EVT patients with SR. Methods: In a prospectively maintained database, we analyzed consecutive patients with SR (mTICI 2b-3) after EVT for anterior circulation large vessel occlusion undergoing post-gadolinium MRI scans at 3-6h and 24h after thrombectomy. Results: Among 48 SR patients meeting study entry criteria, the HARM sign was present in 65%. Patients with HARM sign, compared to those without, did not differ in age or NIHSS, but were more often female (54% vs 10%), more often had history of hypertension (65% vs 47%), and had higher initial SBP (156 vs 144). Patients with HARM sign more often received IV TPA (39% vs 29%), had longer time from onset to achievement of SR (median 352 vs 264 mins), underwent more passes (2.5 vs 1.9), and less often had complete (mTICI 3) reperfusion (13% vs 41%). With regard to outcomes, HARM patients more often had radiologic hemorrhage (75% vs 24%), less often were ambulatory at discharge (23% vs 59%), had less functional independence (mRS 0-2) at 90d (33% vs 59%), and had higher in-hospital mortality (16% vs 0%). Conclusion: The HARM sign is present in two-thirds of EVT patients with successful reperfusion; is associated with higher blood pressure, IV lytic therapy, longer time to reperfusion, more procedure manipulations, and less than complete macro-reperfusion; and is strongly associated with hemorrhagic transformation and worse clinical outcomes. The HARM sign is a promising biomarker for use in trials of treatments to avert reperfusion injury.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Abstract TMP90: The Harm Sign As A Trial Biomarker Of Reperfusion Injury: Frequency, Determinants, And Outcomes In EVT Patients With Successful Reperfusion
- Date Crossref
- 01/02/2023
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The University of Texas Health Science Center at Houston pays non établi dans la noticeUniversité ou école supérieure
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University of California pays non établi dans la noticeUniversité ou école supérieure
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UCLA Health pays non établi dans la noticeÉtablissement de santé
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Univ of Texas Health Science Cntr at Houston Neurology pays non établi dans la noticeUniversité ou école supérieure
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David S Liebeskind UCLA pays non établi dans la noticeInstitution
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Reza Jahan UCLA pays non établi dans la noticeInstitution
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Bryan Yoo UCLA pays non établi dans la noticeInstitution
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Neal M Rao UCLA pays non établi dans la noticeInstitution
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May Nour UCLA pays non établi dans la noticeInstitution
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Interventional Neuroradiology pays non établi dans la noticeInstitution
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Latisha K Sharma UCLA pays non établi dans la noticeInstitution
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Sidney Starkman UCLA pays non établi dans la noticeInstitution
The University of Texas Health Science Center at Houston, University of California et UCLA Health, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.