Evidence map›Paper›PMID 34359354›Full record

ArticleDiagnostics (Basel, Switzerland)2021

Course of Early Neurologic Symptom Severity after Endovascular Treatment of Anterior Circulation Large Vessel Occlusion Stroke: Association with Baseline Multiparametric CT Imaging and Clinical Parameters.

Matthias Philipp Fabritius, Teresa A Wölfer, Moriz Herzberg, Steffen Tiedt, Daniel Puhr-Westerheide, Sergio Grosu, Stefan Maurus, Thomas Geyer, Adrian Curta, Lars Kellert and 7 more

Abstract read
In one paragraph

Article in Diagnostics (Basel, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Matthias Philipp FabritiusDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.ORCID 0000-0002-3471-4701
Teresa A WölferInstitute for Stroke and Dementia Research, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Moriz HerzbergDepartment of Diagnostic and Interventional Radiology, University Hospital Würzburg, Josef-Schneider-Straße 2, 97080 Würzburg, Germany.ORCID 0000-0002-8799-9333
Steffen TiedtInstitute for Stroke and Dementia Research, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Daniel Puhr-WesterheideDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Sergio GrosuDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Stefan MaurusDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Thomas GeyerDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Adrian CurtaDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.ORCID 0000-0003-1056-2149
Lars KellertDepartment of Neurology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Clemens KüpperDepartment of Neurology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Thomas LiebigInstitute of Neuroradiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Jens RickeDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Konstantinos DimitriadisInstitute for Stroke and Dementia Research, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Wolfgang G KunzDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.ORCID 0000-0002-5021-1952
Hanna ZimmermannInstitute of Neuroradiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Paul ReidlerDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeurologic symptom severity and deterioration at 24 hours (h) predict long-term outcomes in patients with acute large vessel occlusion (LVO) stroke of the anterior circulation. We aimed to examine the association of baseline multiparametric CT imaging and clinical factors with the course of neurologic symptom severity in the first 24 h after endovascular treatment (EVT).

methodsPatients with LVO stroke of the anterior circulation were selected from a prospectively acquired consecutive cohort of patients who underwent multiparametric CT, including non-contrast CT, CT angiography and CT perfusion before EVT. The symptom severity was assessed on admission and after 24 h using the 42-point National Institutes of Health Stroke Scale (NIHSS). Clinical and imaging data were compared between patients with and without early neurological deterioration (END). END was defined as an increase in ≥4 points, and a significant clinical improvement as a decrease in ≥4 points, compared to NIHSS on admission. Multivariate regression analyses were used to determine independent associations of imaging and clinical parameters with NIHSS score increase or decrease in the first 24 h.

resultsA total of 211 patients were included, of whom 38 (18.0%) had an END. END was significantly associated with occlusion of the internal carotid artery (odds ratio (OR), 4.25; 95% CI, 1.90-9.47) and the carotid T (OR, 6.34; 95% CI, 2.56-15.71), clot burden score (OR, 0.79; 95% CI, 0.68-0.92) and total ischemic volume (OR, 1.01; 95% CI, 1.00-1.01). In a comprehensive multivariate analysis model including periprocedural parameters and complications after EVT, carotid T occlusion remained independently associated with END, next to reperfusion status and intracranial hemorrhage. Favorable reperfusion status and small ischemic core volume were associated with clinical improvement after 24 h.

conclusionsThe use of imaging parameters as a surrogate for early NIHSS progression in an acute LVO stroke after EVT reached limited performance with only carotid T occlusion as an independent predictor of END. Reperfusion status and early complications in terms of intracranial hemorrhage are critical factors that influence patient outcome in the acute stroke phase after EVT.

Indexed as

CT angiographyCT perfusionEVTlarge vessel occlusionmultiparametric CTNIHSSstroke

Identifiers

PMID34359354
PMCPMC8303279

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.