ArticleNeurology2024
Clinical and Imaging Features Associated With Fast Infarct Growth During Interhospital Transfers of Patients With Large Vessel Occlusions.
Article in Neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Perfusion stability in acute stroke: An observational study exploiting repeated CTP imaging.European journal of radiology open · 2026Article
- Comprehensive Assessment of Arterial, Tissue, and Venous Collaterals for Evaluating the Infarct Growth Rate: The Multimodal Collateral Score.Annals of clinical and translational neurology · 2026Article
- Cerebral Infarction: Epidemiology, Classification, Mechanisms, Diagnosis, and Management.MedComm · 2026Review
- Association of the hsCRP- triglyceride-glucose index (CTI) with early infarct growth rate in acute ischemic stroke due to large artery occlusion.Frontiers in aging neuroscience · 2026Article
- Hemorrhagic transformation during inter-hospital transfer for thrombectomy: Incidence, associated factors, and relationship with outcome.European stroke journal · 2026Article
- Association of Computed Tomography Perfusion Parameters with 90-Day Functional Independence After Endovascular Thrombectomy.Journal of clinical medicine · 2025Article
- Hypodensity Beyond the Ischemic Core: Penumbral Changes Detected With Relative Noncontrast Computed Tomography.Stroke · 2025Observational
- Association of hypoperfusion intensity ratio and cerebral blood volume Index with good outcome in patients transferred for thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Hemorrhagic transformation during inter-hospital transfer for thrombectomy: Incidence, associated factors, and relationship with outcome.European stroke journal · 2025Article
- Review
- Predictive value of heart rate for prognosis in patients with cerebral infarction without atrial fibrillation comorbidity analyzed according to the MIMIC-IV database.Frontiers in neurology · 2025Article
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11 authors.
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Abstract
BACKGROUND AND
objectivesAcute ischemic stroke patients with a large vessel occlusion (LVO) who present to a primary stroke center (PSC) often require transfer to a comprehensive stroke center (CSC) for thrombectomy. Not much is known about specific characteristics at the PSC that are associated with infarct growth during transfer. Gaining more insight into these features could aid future trials with cytoprotective agents targeted at slowing infarct growth. We aimed to identify baseline clinical and imaging characteristics that are associated with fast infarct growth rate (IGR) during interhospital transfer.
methodsWe included patients from the CT Perfusion to Predict Response to Recanalization in Ischemic Stroke Project, a prospective multicenter study. Patients with an anterior circulation LVO who were transferred from a PSC to a CSC for consideration of thrombectomy were eligible if imaging criteria were fulfilled. A CT perfusion (CTP) needed to be obtained at the PSC followed by an MRI at the CSC, before consideration of thrombectomy. The interhospital IGR was defined as the difference between the infarct volumes on MRI and CTP, divided by the time between the scans. Multivariable logistic regression was used to determine characteristics associated with fast IGR (≥5 mL/h).
resultsA total of 183 patients with a median age of 74 years (interquartile range 61-82), of whom 99 (54%) were male and 82 (45%) were fast progressors, were included. At baseline, fast progressors had a higher NIH Stroke Scale score (median 16 vs 13), lower cerebral blood volume index (median 0.80 vs 0.89), more commonly poor collaterals on CT angiography (35% vs 13%), higher hypoperfusion intensity ratios (HIRs) (median 0.51 vs 0.34), and larger core volumes (median 11.80 mL vs 0.00 mL). In multivariable analysis, higher HIR (adjusted odds ratio [aOR] for every 0.10 increase 1.32 [95% CI 1.10-1.59]) and larger core volume (aOR for every 10 mL increase 1.54 [95% CI 1.20-2.11]) remained independently associated with fast IGR. DISCUSSION: Fast infarct growth during interhospital transfer of acute stroke patients is associated with imaging markers of poor collaterals on baseline imaging. These markers are promising targets for patient selection in cytoprotective trials aimed at reducing interhospital infarct growth.
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