TY - T1的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)JF -神经学乔-神经病学SP - e790 LP - - 10.1212 / WNL e801做。首页0000000000013210六世- 98 - 8 AU -费利克斯·c·Ng盟-狮子座Churilov盟Nawaf Yassi AU -盖约翰Kleinig盟文森特Thijs AU -泰迪吴盟沾光沙AU -海伦杜威盟Gagan Sharma谈话盟-帕特里夏·德斯蒙德盟-伯纳德燕盟-马克·帕森斯盟-杰弗里唐南AU -斯蒂芬·戴维斯盟-彼得·米切尔盟-布鲁斯坎贝尔Y1 - 2022/02/22 UR - //www.ez-admanager.com/content/98/8/e790.abstract N2 -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macrovascular血管造影再灌注(无复流)在人类中风仍然是有争议的。首页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Deficits-Intra-Arterial (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。视觉可见的无复流定义为地区持续灌注不足相对脑血容量或流地图内的梗塞和定量验证的在15%不对称而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%)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。患者无复流平均25.2%(四分位范围16.4% - -32.2%,p & lt;0.00001)相对脑血容量减少interside和19.1%(四分位范围3.9% - -28.3%,p = 0.00011)相对脑血流量减少,但类似的平均运输时间(中位数−3.3%,四分位范围−11.9%至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。 The presence of no-reflow was associated with hemorrhagic transformation (adjusted odds ratio [aOR] 1.79, 95% confidence interval [CI] 2.32–15.57, p = 0.0002), greater infarct growth (β = 11.00, 95% CI 5.22–16.78, p = 0.00027), reduced NIH Stroke Scale score improvement at 24 hours (β = −4.06, 95% CI 6.78–1.34, p = 0.004) and being dependent or dead at 90 days as assessed by the modified Rankin Scale (aOR 3.72, 95% CI 1.35–10.20, p = 0.011) in multivariable analysis.Discussion Cerebral no-reflow in humans is common, can be detected by its characteristic perfusion imaging profile using readily available sequences in the clinical setting, and is associated with posttreatment complications and being dependent or dead. 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–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 ER -