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Cited 2 time in webofscience Cited 2 time in scopus
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Impact of the Penumbral Pattern on Clinical Outcome in Patients with Successful Endovascular Revascularization

Authors
Chung, Jong-WonKim, Jun YupPark, Hong-KyunKim, Beom JoonHan, Moon-KuLee, JunChoi, Kang-HoKim, Joon-TaeJung, CheolkyuKim, Jae HyoungKwon, O-KiOh, Chang WanLee, JuneyoungBae, Hee-Joon
Issue Date
Feb-2017
Publisher
ELSEVIER SCIENCE BV
Keywords
Stroke; endovascular treatment; revascularization; penumbra; time
Citation
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, v.26, no.2, pp 360 - 367
Pages
8
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
Volume
26
Number
2
Start Page
360
End Page
367
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/5293
DOI
10.1016/j.jstrokecerebrovasdis.2016.09.031
ISSN
1052-3057
1532-8511
Abstract
Background: In patients with acute ischemic stroke, the impact of penumbral patterns on clinical outcomes after endovascular treatment (EVT) remains controversial. We aimed to establish whether penumbral patterns are associated with clinical outcome after successful recanalization with EVT while adjusting for onset to revascularization time. Materials and Methods: Using a web-based, multicenter, prospective stroke registry database, we identified patients with acute ischemic stroke who underwent perfusion and diffusion magnetic resonance imaging (MRI) before EVT, had anterior circulation stroke, received EVT within 12 hours of symptom onset, and had successful revascularization confirmed during EVT. Based on pretreatment MRI, patients were stratified as having a favorable or nonfavorable penumbral pattern. Onset to revascularization time was dichotomized by median value. Primary outcome was functional independence (modified Rankin Scale score = 2) at 90 days. Findings: Among 121 eligible patients from three university hospitals, 104 (86.0%) had a favorable penumbral pattern, and the median time to revascularization was 271 minutes (interquartile range, 196-371). The functionally independent patient proportion was higher in those with a favorable penumbral pattern than in those without (53.8% versus 5.9%; P <.001), but was not different between early and late revascularization groups (49.2% versus 45.0%; P =.65). The favorable penumbral pattern was associated with functional independence after adjusting confounders (odds ratio, 23.25; 95% confidence interval: 1.58-341.99; P =.02). Time to revascularization did not modify the association (P for interaction,.53). Conclusion: A favorable penumbral pattern is associated with improved functional independence in patients with endovascular revascularization, and the association was not time-dependent.
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