title: Association of Cortical Vein Filling with Clot Location and Clinical Outcomes in Acute Ischaemic Stroke Patients.
abstract: Delay in cortical vein filling during the late-venous phase (delayed-LCVF) is characterized by opacification of cerebral veins despite contrast clearance from contralateral veins on dynamic computed tomography angiography (dCTA) in acute ischemic stroke (AIS) patients. The aim of the study was to investigate the associations of delayed-LCVF with clot location, reperfusion status at 24 hours, and 90-days functional outcome in AIS patients who received reperfusion therapy. A prospective cohort of AIS patients treated with intravenous thrombolysis was studied. Groupwise comparison, univariate, and multivariate regression analyses were used to study the association of delayed-LCVF with clot location and clinical outcomes. Of 93 patients (mean age = 72 ± 12 years) with hemispheric AIS included in the study, 46 (49%) demonstrated delayed-LCVF. Patients with delayed-LCVF demonstrated a significantly higher proportion of proximal occlusion (72% vs 13%, P =< 0.0001), and poor reperfusion at 24 hours (41% vs 11%, P = 0.001). The proportion of poor functional outcome at 90 days was not significantly different (22/56 (48%) vs 17/61 (36%), P = 0.297). The appearance of delayed-LCVF on baseline dCTA may be a surrogate for large vessel occlusion, and an early marker for poor 24-hour angiographic reperfusion.
authors.affiliation: Department of Neurology, John Hunter Hospital, University of Newcastle, Australia.|Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Australia.
authors.forename: Sonu
authors.initials: S
authors.lastname: Bhaskar
authors.affiliation: Department of Neurology, John Hunter Hospital, University of Newcastle, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bivard
authors.affiliation: Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Stanwell
authors.affiliation: Centre for Clinical Epidemiology &Biostatistics, Hunter Medical Research Institute, University of Newcastle, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Attia
authors.affiliation: Department of Neurology, John Hunter Hospital, University of Newcastle, Australia.|Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Parsons
authors.affiliation: Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Australia.|Centre for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Nilsson
authors.affiliation: Department of Neurology, John Hunter Hospital, University of Newcastle, Australia.|Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Levi
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D015424:Reperfusion; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging; D016896:Treatment Outcome