@article {Nge790作者={费利克斯·c·Ng和列昂尼德•Churilov Nawaf Yassi和蒂莫西·约翰Kleinig文森特Thijs和泰迪吴沾光沙和海伦杜威和Gagan沙玛和帕特里夏·德斯蒙德和伯纳德燕和马克谈话帕森斯和杰弗里·唐南和斯蒂芬·戴维斯和彼得·米切尔和布鲁斯坎贝尔},title ={微血管组织再灌注受损的患病率和意义尽管Macrovascular血管造影再灌注(无复流)},体积={98}={8},页面= {e790——e801} = {2022}, doi = {10.1212 / WNL。出版商0000000000013210}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标的相关性损伤微血管组织水平再灌注尽管完成上游macrovascula首页r血管造影再灌注(无复流)在人类中风仍然是有争议的。我们调查的患病率和clinical-radiologic特性这一现象及其对成果。在指定后续3国际随机对照试验血栓切除术灌注成像。方法的汇集分析延长溶栓时间紧急的神经赤字{\ textendash}动脉内的(EXTEND-IA;ClinicalTrials.gov NCT01492725), Tenecteplase与溶栓前血管内治疗缺血性中风(EXTEND-IA秋明石油公司;NCT02388061),确定最佳剂量的Tenecteplase在血管内治疗缺血性中风(EXTEND-IA秋明石油公司第2部分;NCT03340493)试验,最终血管造影患者发生血栓切除术治疗脑梗死的得分2 c扩大到3分,前循环大血管闭塞和24小时随访CT或MRI灌注成像是包括在内。无复流定义为区域的视觉可见的持续低灌注在相对脑血容量或流量地图内的梗塞和定量验证\ > 15 \ %不对称比同族体在没有镜子的颈动脉狭窄或reocclusion。地区无复流的结果确定在33 130名患者(25.3 \ %),包含60.2 \ %的中位数(四分位范围47.8 \ 70.7 \ %)% {\ textendash}的梗塞体积,和参与皮层下(n = 26 33, 78.8 \ %)和皮质(n = 10 33, 30.3 \ %)地区。患者无复流的中位数25.2 \ %(四分位范围16.4 \ % {\ textendash} \ % 32.2, p \ < 0.00001)相对脑血容量减少interside和19.1 \ %(四分位范围3.9 \ % {\ textendash} \ % 28.3, p = 0.00011)相对脑血流量减少,但类似的平均运输时间(平均-3.3 \ %,四分位范围-11.9 \ 24.4 \ % %,p = 0.24)在梗塞的地区。患者基线特征之间的相似和那些没有无复流。无复流的存在与出血性转换(调整优势比(aOR)为1.79,95 \ %可信区间[CI] 2.32 {\ textendash} 15.57, p = 0.0002),更大的梗塞增长(β= 11.00,95 \ % CI 5.22 {\ textendash} 16.78, p = 0.00027),减少了NIH卒中量表评分改善在24小时(β= -4.06,95 \ % CI 6.78 {\ textendash} 1.34, p = 0.004)和被依赖或死在90天的改良Rankin规模(优势比3.72,95 \ % CI 1.35 {\ textendash} 10.20, p = 0.011)在多变量分析。讨论脑无复流在人类中很常见,可以检测到其特点灌注成像在临床使用现成的序列,并与治疗后的并发症和被依赖或死亡。 Further studies evaluating the role of no-reflow in secondary injury after angiographic reperfusion are warranted.Classification of Evidence This study provides Class II evidence that cerebral no-reflow on CT/MRI perfusion imaging at 24 hours is associated with posttreatment complications and poor 3-month functional outcome.CI=confidence interval; DWI=diffusion-weighted imaging; eTICI=expanded Treatment in Cerebral Ischemia; EXTEND-IA=Extending the Time for Thrombolysis in Emergency Neurological Deficits{\textendash}Intra-Arterial; EXTEND-IA TNK=Tenecteplase Versus Alteplase Before Endovascular Therapy for Ischemic Stroke; EXTEND-IA TNK Part 2=Determining the Optimal Dose of Tenecteplase Before Endovascular Therapy for Ischaemic Stroke; FIV=follow-up infarct volume; IQR=interquartile range; MR=magnetic resonance; MRP=MR perfusion imaging; MTT=mean transit time; NIHSS=NIH Stroke Scale; rCBF=relative cerebral blood flow; rCBV=relative cerebral blood volume}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/98/8/e790}, eprint = {//www.ez-admanager.com/content/98/8/e790.full.pdf}, journal = {Neurology} }