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Abstract 31: Penumbra Consumption Rates Based on T Max Delay and Reperfusion Status: A Post-Hoc Analysis of the Defuse-3 Trial

Publication ,  Conference
Yaghi, S; Raz, E; Dehkharghani, S; Riina, H; McTaggart, R; Jayaraman, MV; Prabhakaran, S; Liebeskind, DS; Khatri, P; Mac Grory, BC; Albers, GW ...
Published in: Stroke
March 2021

In patients with acute large vessel occlusion, the definition of penumbral tissue based on T max delay perfusion imaging is not well established in relation to late-window endovascular thrombectomy (EVT). In this study, we sought to evaluate penumbra consumption rates for T max delays in patients treated between 6 and 16 hours from last known normal. This is a secondary analysis of the DEFUSE-3 trial, which included patients with an acute ischemic stroke due to anterior circulation occlusion within 6-16 hours of last known normal. The primary outcome is percentage penumbra consumption defined as (24 hour infarct volume-core infarct volume)/(Tmax volume-baseline core volume). We stratified the cohort into 4 categories (untreated, TICI 0-2a, TICI 2b, and TICI3) and calculated penumbral consumption rates. We included 143 patients, of which 66 were untreated, 16 had TICI 0-2a, 46 had TICI 2b, and 15 had TICI 3. In untreated patients, a median (IQR) of 48% (21% - 85%) of penumbral tissue was consumed based on Tmax6 as opposed to 160.6% (51% - 455.2%) of penumbral tissue based on Tmax10. On the contrary, in patients achieving TICI 3 reperfusion, a median (IQR) of 5.3% (1.1% - 14.6%) of penumbral tissue was consumed based on Tmax6 and 25.7% (3.2% - 72.1%) of penumbral tissue based on Tmax10. Contrary to prior studies, we show that at least 75% of penumbral tissue with Tmax > 10 sec delay can be salvaged with successful reperfusion and new generation devices. In untreated patients, since infarct expansion can occur beyond 24 hours, future studies with delayed brain imaging are needed to determine the optimal T max delay threshold that defines penumbral tissue in patients with proximal anterior circulation large vessel occlusion.

Duke Scholars

Published In

Stroke

DOI

EISSN

1524-4628

ISSN

0039-2499

Publication Date

March 2021

Volume

52

Issue

Suppl_1

Publisher

Ovid Technologies (Wolters Kluwer Health)

Related Subject Headings

  • Neurology & Neurosurgery
  • 4201 Allied health and rehabilitation science
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

APA
Chicago
ICMJE
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Yaghi, S., Raz, E., Dehkharghani, S., Riina, H., McTaggart, R., Jayaraman, M. V., … De Havenon, A. H. (2021). Abstract 31: Penumbra Consumption Rates Based on T Max Delay and Reperfusion Status: A Post-Hoc Analysis of the Defuse-3 Trial. In Stroke (Vol. 52). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1161/str.52.suppl_1.31
Yaghi, Shadi, Eytan Raz, Seena Dehkharghani, Howard Riina, Ryan McTaggart, Mahesh V. Jayaraman, Shyam Prabhakaran, et al. “Abstract 31: Penumbra Consumption Rates Based on T Max Delay and Reperfusion Status: A Post-Hoc Analysis of the Defuse-3 Trial.” In Stroke, Vol. 52. Ovid Technologies (Wolters Kluwer Health), 2021. https://doi.org/10.1161/str.52.suppl_1.31.
Yaghi S, Raz E, Dehkharghani S, Riina H, McTaggart R, Jayaraman MV, et al. Abstract 31: Penumbra Consumption Rates Based on T Max Delay and Reperfusion Status: A Post-Hoc Analysis of the Defuse-3 Trial. In: Stroke. Ovid Technologies (Wolters Kluwer Health); 2021.
Yaghi, Shadi, et al. “Abstract 31: Penumbra Consumption Rates Based on T Max Delay and Reperfusion Status: A Post-Hoc Analysis of the Defuse-3 Trial.” Stroke, vol. 52, no. Suppl_1, Ovid Technologies (Wolters Kluwer Health), 2021. Crossref, doi:10.1161/str.52.suppl_1.31.
Yaghi S, Raz E, Dehkharghani S, Riina H, McTaggart R, Jayaraman MV, Prabhakaran S, Liebeskind DS, Khatri P, Mac Grory BC, Lansberg MG, Albers GW, De Havenon AH. Abstract 31: Penumbra Consumption Rates Based on T Max Delay and Reperfusion Status: A Post-Hoc Analysis of the Defuse-3 Trial. Stroke. Ovid Technologies (Wolters Kluwer Health); 2021.

Published In

Stroke

DOI

EISSN

1524-4628

ISSN

0039-2499

Publication Date

March 2021

Volume

52

Issue

Suppl_1

Publisher

Ovid Technologies (Wolters Kluwer Health)

Related Subject Headings

  • Neurology & Neurosurgery
  • 4201 Allied health and rehabilitation science
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology