title: Predictors of reperfusion in patients with acute ischemic stroke.
abstract: OBJECTIVE
  Ischemic stroke studies emphasize a difference between reperfusion and recanalization, but predictors of reperfusion have not been elucidated. The aim of this study was to evaluate the relationship between reperfusion and recanalization and identify predictors of reperfusion.
  
  
  METHODS
  From the Dutch Acute Stroke Study, 178 patients were selected with an MCA territory deficit on admission CTP and day 3 follow-up CTP and CTA. Reperfusion was evaluated on CTP, and recanalization on CTA, follow-up imaging. Reperfusion percentages were calculated in patients with and without recanalization. Patient admission and treatment characteristics and admission CT imaging parameters were collected. Their association with complete reperfusion was analyzed by using univariate and multivariate logistic regression.
  
  
  RESULTS
  Sixty percent of patients with complete recanalization showed complete reperfusion (relative risk, 2.60; 95% CI, 1.63-4.13). Approximately one-third of patients showed some discrepancy between recanalization and reperfusion status. Lower NIHSS score (OR, 1.06; 95% CI, 1.01-1.11), smaller infarct core size (OR, 3.11; 95% CI, 1.46-6.66; and OR, 2.40; 95% CI, 1.14-5.02), smaller total ischemic area (OR, 4.20; 95% CI, 1.91-9.22; and OR, 2.35; 95% CI, 1.12-4.91), lower clot burden (OR, 1.35; 95% CI, 1.14-1.58), distal thrombus location (OR, 3.02; 95% CI, 1.76-5.20), and good collateral score (OR, 2.84; 95% CI, 1.34-6.02) significantly increased the odds of complete reperfusion. In multivariate analysis, only total ischemic area (OR, 6.12; 95% CI, 2.69-13.93; and OR, 1.91; 95% CI, 0.91-4.02) was an independent predictor of complete reperfusion.
  
  
  CONCLUSIONS
  Recanalization and reperfusion are strongly associated but not always equivalent in ischemic stroke. A smaller total ischemic area is the only independent predictor of complete reperfusion.
authors.affiliation: From the Department of Radiology (A.D.H., J.W.D., J.M.N., T.v.S., I.C.v.d.S., W.P.Th.M.M., B.K.V.), University Medical Center Utrecht, Utrecht, the Netherlands Department of Radiology (A.D.H.), Rijnstate Hospital, Arnhem, the Netherlands alexanderhorsch@gmail.com.
authors.forename: A D
authors.initials: AD
authors.lastname: Horsch
authors.affiliation: From the Department of Radiology (A.D.H., J.W.D., J.M.N., T.v.S., I.C.v.d.S., W.P.Th.M.M., B.K.V.), University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: Dankbaar
authors.affiliation: From the Department of Radiology (A.D.H., J.W.D., J.M.N., T.v.S., I.C.v.d.S., W.P.Th.M.M., B.K.V.), University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Niesten
authors.affiliation: From the Department of Radiology (A.D.H., J.W.D., J.M.N., T.v.S., I.C.v.d.S., W.P.Th.M.M., B.K.V.), University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van Seeters
authors.affiliation: From the Department of Radiology (A.D.H., J.W.D., J.M.N., T.v.S., I.C.v.d.S., W.P.Th.M.M., B.K.V.), University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: I C
authors.initials: IC
authors.lastname: van der Schaaf
authors.affiliation: Julius Center for Health Sciences and Primary Care (Y.v.d.G.), Utrecht, the Netherlands.
authors.forename: Y
authors.initials: Y
authors.lastname: van der Graaf
authors.affiliation: From the Department of Radiology (A.D.H., J.W.D., J.M.N., T.v.S., I.C.v.d.S., W.P.Th.M.M., B.K.V.), University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: W P Th M
authors.initials: WP
authors.lastname: Mali
authors.affiliation: From the Department of Radiology (A.D.H., J.W.D., J.M.N., T.v.S., I.C.v.d.S., W.P.Th.M.M., B.K.V.), University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: B K
authors.initials: BK
authors.lastname: Velthuis
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018919:Neovascularization, Physiologic / Q000502:physiology*; D015427:Reperfusion Injury / Q000000981:diagnostic imaging*; D020521:Stroke / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome