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Article

Low Hypoperfusion Intensity Ratio Is Associated with a Favorable Outcome Even in Large Ischemic Core and Delayed Recanalization Time

1
Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 10415, Korea
2
Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
3
Integrative Research Institute for Cerebral and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul 03722, Korea
4
Department of Neurology, National Health Insurance Service Ilsan Hospital, Ilsan 10444, Korea
5
Department of Neurology, Seoul Medical Center, Seoul 02053, Korea
6
Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
*
Author to whom correspondence should be addressed.
Academic Editor: Peter Sporns
J. Clin. Med. 2021, 10(9), 1869; https://doi.org/10.3390/jcm10091869
Received: 18 March 2021 / Revised: 21 April 2021 / Accepted: 22 April 2021 / Published: 26 April 2021
(This article belongs to the Special Issue Thrombolysis and Thrombectomy in Acute Ischemic Stroke)
In ischemic brain tissue, hypoperfusion severity can be assessed using the hypoperfusion intensity ratio (HIR). We evaluated the link between HIR and clinical outcomes after successful recanalization by endovascular treatment. We retrospectively reviewed 162 consecutive patients who underwent endovascular treatment for intracranial large vessel occlusion. The HIR was calculated using an automated software program, with initial computed tomography perfusion images. The HIR was compared between patients with and without favorable outcomes. To observe the modifying effect of the HIR on the well-known major outcome determinants, regression analyses were performed in the low and high HIR groups. The median HIR value was significantly lower in patients with a favorable outcome, with an optimal cut-off point of 0.54. The HIR was an independent factor for a favorable outcome in a specific multivariable model and was significantly correlated with the Alberta Stroke Program Early Computed Tomography Score (ASPECTS). In contrast to the high HIR group, the low HIR group showed that ASPECTS and onset-to-recanalization time were not independently associated with a favorable outcome. Finally, the low HIR group had a more favorable outcome even in cases with an unfavorable ASPECTS and onset-to-recanalization time. The HIR could be useful in predicting outcomes after successful recanalization. View Full-Text
Keywords: hypoperfusion; collaterality; stroke; outcome; thrombectomy hypoperfusion; collaterality; stroke; outcome; thrombectomy
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MDPI and ACS Style

Baek, J.-H.; Kim, Y.D.; Lee, K.J.; Choi, J.K.; Baik, M.; Kim, B.M.; Kim, D.J.; Heo, J.H.; Nam, H.S. Low Hypoperfusion Intensity Ratio Is Associated with a Favorable Outcome Even in Large Ischemic Core and Delayed Recanalization Time. J. Clin. Med. 2021, 10, 1869. https://doi.org/10.3390/jcm10091869

AMA Style

Baek J-H, Kim YD, Lee KJ, Choi JK, Baik M, Kim BM, Kim DJ, Heo JH, Nam HS. Low Hypoperfusion Intensity Ratio Is Associated with a Favorable Outcome Even in Large Ischemic Core and Delayed Recanalization Time. Journal of Clinical Medicine. 2021; 10(9):1869. https://doi.org/10.3390/jcm10091869

Chicago/Turabian Style

Baek, Jang-Hyun, Young D. Kim, Ki J. Lee, Jin K. Choi, Minyoul Baik, Byung M. Kim, Dong J. Kim, Ji H. Heo, and Hyo S. Nam. 2021. "Low Hypoperfusion Intensity Ratio Is Associated with a Favorable Outcome Even in Large Ischemic Core and Delayed Recanalization Time" Journal of Clinical Medicine 10, no. 9: 1869. https://doi.org/10.3390/jcm10091869

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