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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.1K

Comprehensive Venous Outflow Predicts Functional Outcomes in Patients with Acute Ischemic Stroke Treated by

G Adusumilli1, T D Faizy2, S Christensen3

  • 1From the Department of Radiology (G.A.), Massachusetts General Hospital, Boston, Massachusetts.

AJNR. American Journal of Neuroradiology
|May 18, 2023
PubMed

Insights

A new comprehensive venous outflow score, combining cortical and deep venous drainage, accurately predicts outcomes in acute ischemic stroke patients undergoing thrombectomy. Favorable venous profiles correlate with better functional independence and reperfusion rates.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Medical Imaging

Background:

  • Cortical venous outflow is a key indicator of collateral blood flow in acute ischemic stroke.
  • Assessing deep venous drainage alongside cortical venous outflow may offer further insights for patient treatment.

Purpose of the Study:

  • To develop and validate a comprehensive venous outflow score for acute ischemic stroke patients.
  • To evaluate the association between this comprehensive score and patient outcomes after thrombectomy.

Main Methods:

  • A multicenter retrospective cohort study included 678 patients with acute ischemic stroke treated by thrombectomy.
  • A comprehensive venous outflow score (0-8) was created by combining internal cerebral vein and cortical vein opacification scores.
  • Outcome analyses utilized Mann-Whitney U and chi-squared tests to compare functional independence and reperfusion rates.

Main Results:

  • Patients with favorable comprehensive venous outflow (n=315) showed significantly higher rates of functional independence (66% vs 11%, P<.001) and excellent reperfusion (53% vs 40%, P<.001) compared to those with unfavorable outflow (n=363).
  • The comprehensive venous outflow score demonstrated a stronger association with modified Rankin Scale (mRS) scores than the cortical vein opacification score alone (-0.74 vs -0.67, P=.006).

Conclusions:

  • A favorable comprehensive venous profile is a strong predictor of functional independence and excellent reperfusion post-thrombectomy.
  • Further research should investigate cases where venous outflow status does not align with patient outcomes.
Abstract

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