Too good to treat? Ischemic stroke patients with small computed tomography perfusion lesions may not benefit from thrombolysis.
#SWIFT NOTE COLLATERAL SERIAL#
Admission diffusion-weighted imaging lesion volume in patients with large vessel occlusion stroke and Alberta Stroke Program Early CT Score of ≥6 points: serial computed tomography-magnetic resonance imaging collateral measurements. Patients with low Alberta Stroke Program Early CT Score (ASPECTS) but good collaterals benefit from endovascular recanalization. Collateral circulation predicts the size of the infarct core and the proportion of salvageable penumbra in hyperacute ischemic stroke patients treated with intravenous thrombolysis. Endovascular treatment versus medical care alone for ischaemic stroke: systematic review and meta-analysis. Rodrigues FB, Neves JB, Caldeira D, et al. Endovascular vs medical management of acute ischemic stroke. Explainable machine-learning predictions for the prevention of hypoxaemia during surgery. From local explanations to global understanding with explainable AI for trees. Proc ACM SIGKDD Int Conf Knowl Discov Data Min. XGBoost: a scalable tree boosting system. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Powers WJ, Rabinstein AA, Ackerson T, et al. Machine learning for brain stroke: a review. Use of machine learning models to predict death after acute myocardial infarction. Use of machine learning to develop and evaluate models using preoperative and intraoperative data to identify risks of postoperative complications. Collateral perfusion using arterial spin labeling in symptomatic versus asymptomatic middle cerebral artery stenosis. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. Thrombectomy within 8 hours after symptom onset in ischemic stroke. Randomized assessment of rapid endovascular treatment of ischemic stroke. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Collateral circulation in ischemic stroke: assessment tools and therapeutic strategies. Ischemic core and hypoperfusion volumes predict infarct size in SWIFT PRIME. Identifier: NCT02580097.Īlbers GW, Goyal M, Jahan R, et al. The prediction model that incorporated CCR improved the model’s ability to identify unfavorable outcomes. CCR is a robust predictor of functional outcomes, as identified by ML, in patients with acute LVO. The prediction model incorporating clinical factors, ischemic core volume, collateral perfusion volume, and CCR showed better discriminatory power in predicting unfavorable outcomes than the model without CCR (mean C index 0.853 ± 0.108 versus 0.793 ± 0.133, P = 0.70 mean net reclassification index 52.7% ± 32.7%, P 0.73. Among 129 patients, CCR was identified as the most important variable. An ML model was built and tested with a tenfold cross-validation using nine clinical and four imaging variables with mRS score 3–6 as unfavorable outcomes. Functional outcomes were assessed using the modified Rankin Scale (mRS) at 90 days.
CCR was calculated as collateral perfusion volume/ischemic core volume. Patients with AIS caused by anterior circulation large vessel occlusion (LVO) were recruited from a prospective multicenter study. We aimed to present a new imaging marker, the collateral-core ratio (CCR), to quantify the interaction effect between these factors and evaluate its ability to predict functional outcomes using machine learning (ML) in AIS. However, biomarkers that assess the magnitude of this interaction are still lacking.
The interaction effect between collateral circulation and ischemic core size on stroke outcomes has been highlighted in acute ischemic stroke (AIS).
0 kommentar(er)
