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Infarct Pattern, Perfusion Mismatch Thresholds, and Recurrent Cerebrovascular Events in Symptomatic Intracranial Stenosis.

Publication ,  Journal Article
Yaghi, S; Grory, BM; Prabhakaran, S; Yeatts, SD; Cutting, S; Jayaraman, M; Sacchetti, D; Furie, K; Zaidat, OO; Liebeskind, DS; Khatri, P
Published in: J Neuroimaging
September 2019

BACKGROUND AND PURPOSE: Studies have shown an association between infarct patterns and recurrent stroke in patients with symptomatic intracranial stenosis (sICAS) but there are limited data on associations with perfusion imaging mismatch profile. We aim to determine the association between infarct pattern, optimal mismatch profile definition, and recurrent cerebrovascular events (RCVE) in patients with anterior circulation sICAS. METHODS: This is a retrospective study of consecutive patients with acutely sICAS admitted to a comprehensive stroke center over 18 month's period. Patients with sICAS underwent magnetic resonance perfusion (MRP) imaging within 24 hours from admission. Infarct patterns (internal BZ [IBZ], cortical BZ [CBZ], and core/perforator [C/P]) and RCVE within 90 days, were independently adjudicated by two reviewers. We compared mismatch profiles and recurrent event rates across infarct patterns. RESULTS: Twenty-five patients met inclusion criteria; 28% had IBZ infarcts and overall RCVE rate was 32.0%. When compared to patients without IBZ infarcts, those with IBZ infarcts were more likely to have a target mismatch profile using Tmax > 6 seconds (60% vs. 6.7%, P = .007) and RCVE (62.5% vs. 11.8%, P = .01). There were no associations between CBZ and C/P infarcts and target mismatch profiles and RCVE. CONCLUSION: IBZ infarcts may be a surrogate marker of distal perfusion status and RCVE risk. Larger multicenter, prospective, core-lab blindly adjudicated studies are needed to confirm our findings.

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Published In

J Neuroimaging

DOI

EISSN

1552-6569

Publication Date

September 2019

Volume

29

Issue

5

Start / End Page

640 / 644

Location

United States

Related Subject Headings

  • Stroke
  • Retrospective Studies
  • Prospective Studies
  • Perfusion Imaging
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Humans
  • Female
 

Citation

APA
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ICMJE
MLA
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Yaghi, S., Grory, B. M., Prabhakaran, S., Yeatts, S. D., Cutting, S., Jayaraman, M., … Khatri, P. (2019). Infarct Pattern, Perfusion Mismatch Thresholds, and Recurrent Cerebrovascular Events in Symptomatic Intracranial Stenosis. J Neuroimaging, 29(5), 640–644. https://doi.org/10.1111/jon.12630
Yaghi, Shadi, Brian Mac Grory, Shyam Prabhakaran, Sharon D. Yeatts, Shawna Cutting, Mahesh Jayaraman, Daniel Sacchetti, et al. “Infarct Pattern, Perfusion Mismatch Thresholds, and Recurrent Cerebrovascular Events in Symptomatic Intracranial Stenosis.J Neuroimaging 29, no. 5 (September 2019): 640–44. https://doi.org/10.1111/jon.12630.
Yaghi S, Grory BM, Prabhakaran S, Yeatts SD, Cutting S, Jayaraman M, et al. Infarct Pattern, Perfusion Mismatch Thresholds, and Recurrent Cerebrovascular Events in Symptomatic Intracranial Stenosis. J Neuroimaging. 2019 Sep;29(5):640–4.
Yaghi, Shadi, et al. “Infarct Pattern, Perfusion Mismatch Thresholds, and Recurrent Cerebrovascular Events in Symptomatic Intracranial Stenosis.J Neuroimaging, vol. 29, no. 5, Sept. 2019, pp. 640–44. Pubmed, doi:10.1111/jon.12630.
Yaghi S, Grory BM, Prabhakaran S, Yeatts SD, Cutting S, Jayaraman M, Sacchetti D, Furie K, Zaidat OO, Liebeskind DS, Khatri P. Infarct Pattern, Perfusion Mismatch Thresholds, and Recurrent Cerebrovascular Events in Symptomatic Intracranial Stenosis. J Neuroimaging. 2019 Sep;29(5):640–644.
Journal cover image

Published In

J Neuroimaging

DOI

EISSN

1552-6569

Publication Date

September 2019

Volume

29

Issue

5

Start / End Page

640 / 644

Location

United States

Related Subject Headings

  • Stroke
  • Retrospective Studies
  • Prospective Studies
  • Perfusion Imaging
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Humans
  • Female