Stroke etiologic subtype may influence the rate of hyperdense middle cerebral artery sign disappearance after intravenous thrombolysis

Disappearance of hyperdense middle cerebral artery sign (HMCAS) on non-contrast brain computed tomography (CT) scan is a reliable sign of arterial recanalization after intravenous (IV) thrombolysis for ischemic stroke. We aimed to assess whether stroke etiologic subtype may influence the rate of HMC...

Full description

Saved in:
Bibliographic Details
Published in:Journal of thrombosis and thrombolysis 2017, Vol.43 (1), p.86-90
Main Authors: Forlivesi, Stefano, Bovi, Paolo, Tomelleri, Giampaolo, Micheletti, Nicola, Carletti, Monica, Moretto, Giuseppe, Cappellari, Manuel
Format: Article
Language:English
Subjects:
Administration, Intravenous
Adult
Aged
Cardiology
Female
Fibrinolytic Agents - administration & dosage
Fibrinolytic Agents - therapeutic use
Hematology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Middle Cerebral Artery - pathology
Recovery of Function
Retrospective Studies
Stroke - etiology
Thrombolytic Therapy - methods
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c405t-37000b0c9844e0fc4b25a4c64fe1b3f330997a0c7ac0cd4264d54763270764233
cites cdi_FETCH-LOGICAL-c405t-37000b0c9844e0fc4b25a4c64fe1b3f330997a0c7ac0cd4264d54763270764233
container_end_page 90
container_issue 1
container_start_page 86
container_title Journal of thrombosis and thrombolysis
container_volume 43
creator Forlivesi, Stefano
Bovi, Paolo
Tomelleri, Giampaolo
Micheletti, Nicola
Carletti, Monica
Moretto, Giuseppe
Cappellari, Manuel
description Disappearance of hyperdense middle cerebral artery sign (HMCAS) on non-contrast brain computed tomography (CT) scan is a reliable sign of arterial recanalization after intravenous (IV) thrombolysis for ischemic stroke. We aimed to assess whether stroke etiologic subtype may influence the rate of HMCAS disappearance and the clinical outcome after IV thrombolysis. We conducted a retrospective analysis of data prospectively collected from 1031 consecutive stroke patients treated with IV thrombolysis. Outcome measures were HMCAS disappearance on follow-up CT scan within 22–36 h of IV thrombolysis, neurologic improvement (NIH Stroke Scale [NIHSS] ≤4 points from baseline or NIHSS score of 0) at 7 days, and modified rankin scale (mRS) ≤1 at 3 months. Of 256 patients with HMCAS on admission CT scan, 125 had a cardioembolic stroke, 67 a stroke due to large-artery atherosclerosis (LAA), 58 a stroke of undetermined etiology, and six a stroke secondary to carotid artery dissection. HMCAS disappearance occurred in 145 (56.6 %) patients, neurologic improvement in 122 (55.0 %) patients, and mRS ≤1 in 64 (32.8 %) patients. Compared with cardioembolic stroke patients, patients with stroke due to LAA had lower odds ratios (OR) for HMCAS disappearance (OR 0.29, 95 % CI 0.15–0.58, p 
doi_str_mv 10.1007/s11239-016-1404-x
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1868309205</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1868309205</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-37000b0c9844e0fc4b25a4c64fe1b3f330997a0c7ac0cd4264d54763270764233</originalsourceid><addsrcrecordid>eNqNkU1rFTEUhoNY7LX6A9xIwI2bsSdfk5mllPoBBRdVcBcymTO3qTOTMclI5w_4u5vLrSKC4CqL9zlPzuEl5AWDNwxAnyfGuGgrYHXFJMjq7hHZMaVFpSX_-pjsoOVtpQSoU_I0pVsAaFvgT8gp17JulWh35Od1juEbUsw-jGHvHU1rl7cF6WQ36udhXHF2SPMN0mgz0jDQmxLHHudUIN_3I1KHEbtoR2pjxrjR5Pcz7X2yy4I22oPADiUpwhztD5zDmooyhqkL45Z8ekZOBjsmfP7wnpEv7y4_X3yorj69_3jx9qpyElSuhC43dODaRkqEwcmOKytdLQdknRiEKAdqC05bB66XvJa9kroWXIOuJRfijLw-epcYvq-Yspl8cjiOdsayk2FN3RQJB_UfKK91WUg2BX31F3ob1jiXQwqlGgCmdVsodqRcDClFHMwS_WTjZhiYQ5_m2KcpfZpDn-auzLx8MK_dhP3viV8FFoAfgVSieY_xj6__ab0HLxSs_A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1858001779</pqid></control><display><type>article</type><title>Stroke etiologic subtype may influence the rate of hyperdense middle cerebral artery sign disappearance after intravenous thrombolysis</title><source>Springer Nature</source><creator>Forlivesi, Stefano ; Bovi, Paolo ; Tomelleri, Giampaolo ; Micheletti, Nicola ; Carletti, Monica ; Moretto, Giuseppe ; Cappellari, Manuel</creator><creatorcontrib>Forlivesi, Stefano ; Bovi, Paolo ; Tomelleri, Giampaolo ; Micheletti, Nicola ; Carletti, Monica ; Moretto, Giuseppe ; Cappellari, Manuel</creatorcontrib><description>Disappearance of hyperdense middle cerebral artery sign (HMCAS) on non-contrast brain computed tomography (CT) scan is a reliable sign of arterial recanalization after intravenous (IV) thrombolysis for ischemic stroke. We aimed to assess whether stroke etiologic subtype may influence the rate of HMCAS disappearance and the clinical outcome after IV thrombolysis. We conducted a retrospective analysis of data prospectively collected from 1031 consecutive stroke patients treated with IV thrombolysis. Outcome measures were HMCAS disappearance on follow-up CT scan within 22–36 h of IV thrombolysis, neurologic improvement (NIH Stroke Scale [NIHSS] ≤4 points from baseline or NIHSS score of 0) at 7 days, and modified rankin scale (mRS) ≤1 at 3 months. Of 256 patients with HMCAS on admission CT scan, 125 had a cardioembolic stroke, 67 a stroke due to large-artery atherosclerosis (LAA), 58 a stroke of undetermined etiology, and six a stroke secondary to carotid artery dissection. HMCAS disappearance occurred in 145 (56.6 %) patients, neurologic improvement in 122 (55.0 %) patients, and mRS ≤1 in 64 (32.8 %) patients. Compared with cardioembolic stroke patients, patients with stroke due to LAA had lower odds ratios (OR) for HMCAS disappearance (OR 0.29, 95 % CI 0.15–0.58, p &lt; 0.001), neurologic improvement (OR 0.42, 95 % CI 0.22–0.82, p = 0.011), and mRS ≤1 (OR 0.18, 95 % CI 0.06–0.52, p = 0.002). No significant differences in outcome measures were found between cardioembolic strokes and strokes of undetermined etiology. This study suggests that stroke due to LAA is associated with lower rates of HMCAS disappearance, neurologic improvement, and mRS ≤1 after IV thrombolysis, compared with cardioembolic stroke.</description><identifier>ISSN: 0929-5305</identifier><identifier>EISSN: 1573-742X</identifier><identifier>DOI: 10.1007/s11239-016-1404-x</identifier><identifier>PMID: 27469539</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Administration, Intravenous ; Adult ; Aged ; Cardiology ; Female ; Fibrinolytic Agents - administration &amp; dosage ; Fibrinolytic Agents - therapeutic use ; Hematology ; Humans ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Middle Cerebral Artery - pathology ; Recovery of Function ; Retrospective Studies ; Stroke - etiology ; Thrombolytic Therapy - methods ; Treatment Outcome</subject><ispartof>Journal of thrombosis and thrombolysis, 2017, Vol.43 (1), p.86-90</ispartof><rights>Springer Science+Business Media New York 2016</rights><rights>Journal of Thrombosis and Thrombolysis is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-37000b0c9844e0fc4b25a4c64fe1b3f330997a0c7ac0cd4264d54763270764233</citedby><cites>FETCH-LOGICAL-c405t-37000b0c9844e0fc4b25a4c64fe1b3f330997a0c7ac0cd4264d54763270764233</cites><orcidid>0000-0003-0609-3044</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27469539$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Forlivesi, Stefano</creatorcontrib><creatorcontrib>Bovi, Paolo</creatorcontrib><creatorcontrib>Tomelleri, Giampaolo</creatorcontrib><creatorcontrib>Micheletti, Nicola</creatorcontrib><creatorcontrib>Carletti, Monica</creatorcontrib><creatorcontrib>Moretto, Giuseppe</creatorcontrib><creatorcontrib>Cappellari, Manuel</creatorcontrib><title>Stroke etiologic subtype may influence the rate of hyperdense middle cerebral artery sign disappearance after intravenous thrombolysis</title><title>Journal of thrombosis and thrombolysis</title><addtitle>J Thromb Thrombolysis</addtitle><addtitle>J Thromb Thrombolysis</addtitle><description>Disappearance of hyperdense middle cerebral artery sign (HMCAS) on non-contrast brain computed tomography (CT) scan is a reliable sign of arterial recanalization after intravenous (IV) thrombolysis for ischemic stroke. We aimed to assess whether stroke etiologic subtype may influence the rate of HMCAS disappearance and the clinical outcome after IV thrombolysis. We conducted a retrospective analysis of data prospectively collected from 1031 consecutive stroke patients treated with IV thrombolysis. Outcome measures were HMCAS disappearance on follow-up CT scan within 22–36 h of IV thrombolysis, neurologic improvement (NIH Stroke Scale [NIHSS] ≤4 points from baseline or NIHSS score of 0) at 7 days, and modified rankin scale (mRS) ≤1 at 3 months. Of 256 patients with HMCAS on admission CT scan, 125 had a cardioembolic stroke, 67 a stroke due to large-artery atherosclerosis (LAA), 58 a stroke of undetermined etiology, and six a stroke secondary to carotid artery dissection. HMCAS disappearance occurred in 145 (56.6 %) patients, neurologic improvement in 122 (55.0 %) patients, and mRS ≤1 in 64 (32.8 %) patients. Compared with cardioembolic stroke patients, patients with stroke due to LAA had lower odds ratios (OR) for HMCAS disappearance (OR 0.29, 95 % CI 0.15–0.58, p &lt; 0.001), neurologic improvement (OR 0.42, 95 % CI 0.22–0.82, p = 0.011), and mRS ≤1 (OR 0.18, 95 % CI 0.06–0.52, p = 0.002). No significant differences in outcome measures were found between cardioembolic strokes and strokes of undetermined etiology. This study suggests that stroke due to LAA is associated with lower rates of HMCAS disappearance, neurologic improvement, and mRS ≤1 after IV thrombolysis, compared with cardioembolic stroke.</description><subject>Administration, Intravenous</subject><subject>Adult</subject><subject>Aged</subject><subject>Cardiology</subject><subject>Female</subject><subject>Fibrinolytic Agents - administration &amp; dosage</subject><subject>Fibrinolytic Agents - therapeutic use</subject><subject>Hematology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Middle Cerebral Artery - pathology</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Stroke - etiology</subject><subject>Thrombolytic Therapy - methods</subject><subject>Treatment Outcome</subject><issn>0929-5305</issn><issn>1573-742X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqNkU1rFTEUhoNY7LX6A9xIwI2bsSdfk5mllPoBBRdVcBcymTO3qTOTMclI5w_4u5vLrSKC4CqL9zlPzuEl5AWDNwxAnyfGuGgrYHXFJMjq7hHZMaVFpSX_-pjsoOVtpQSoU_I0pVsAaFvgT8gp17JulWh35Od1juEbUsw-jGHvHU1rl7cF6WQ36udhXHF2SPMN0mgz0jDQmxLHHudUIN_3I1KHEbtoR2pjxrjR5Pcz7X2yy4I22oPADiUpwhztD5zDmooyhqkL45Z8ekZOBjsmfP7wnpEv7y4_X3yorj69_3jx9qpyElSuhC43dODaRkqEwcmOKytdLQdknRiEKAdqC05bB66XvJa9kroWXIOuJRfijLw-epcYvq-Yspl8cjiOdsayk2FN3RQJB_UfKK91WUg2BX31F3ob1jiXQwqlGgCmdVsodqRcDClFHMwS_WTjZhiYQ5_m2KcpfZpDn-auzLx8MK_dhP3viV8FFoAfgVSieY_xj6__ab0HLxSs_A</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>Forlivesi, Stefano</creator><creator>Bovi, Paolo</creator><creator>Tomelleri, Giampaolo</creator><creator>Micheletti, Nicola</creator><creator>Carletti, Monica</creator><creator>Moretto, Giuseppe</creator><creator>Cappellari, Manuel</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0609-3044</orcidid></search><sort><creationdate>2017</creationdate><title>Stroke etiologic subtype may influence the rate of hyperdense middle cerebral artery sign disappearance after intravenous thrombolysis</title><author>Forlivesi, Stefano ; Bovi, Paolo ; Tomelleri, Giampaolo ; Micheletti, Nicola ; Carletti, Monica ; Moretto, Giuseppe ; Cappellari, Manuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-37000b0c9844e0fc4b25a4c64fe1b3f330997a0c7ac0cd4264d54763270764233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Administration, Intravenous</topic><topic>Adult</topic><topic>Aged</topic><topic>Cardiology</topic><topic>Female</topic><topic>Fibrinolytic Agents - administration &amp; dosage</topic><topic>Fibrinolytic Agents - therapeutic use</topic><topic>Hematology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Middle Aged</topic><topic>Middle Cerebral Artery - pathology</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>Stroke - etiology</topic><topic>Thrombolytic Therapy - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Forlivesi, Stefano</creatorcontrib><creatorcontrib>Bovi, Paolo</creatorcontrib><creatorcontrib>Tomelleri, Giampaolo</creatorcontrib><creatorcontrib>Micheletti, Nicola</creatorcontrib><creatorcontrib>Carletti, Monica</creatorcontrib><creatorcontrib>Moretto, Giuseppe</creatorcontrib><creatorcontrib>Cappellari, Manuel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of thrombosis and thrombolysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Forlivesi, Stefano</au><au>Bovi, Paolo</au><au>Tomelleri, Giampaolo</au><au>Micheletti, Nicola</au><au>Carletti, Monica</au><au>Moretto, Giuseppe</au><au>Cappellari, Manuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stroke etiologic subtype may influence the rate of hyperdense middle cerebral artery sign disappearance after intravenous thrombolysis</atitle><jtitle>Journal of thrombosis and thrombolysis</jtitle><stitle>J Thromb Thrombolysis</stitle><addtitle>J Thromb Thrombolysis</addtitle><date>2017</date><risdate>2017</risdate><volume>43</volume><issue>1</issue><spage>86</spage><epage>90</epage><pages>86-90</pages><issn>0929-5305</issn><eissn>1573-742X</eissn><abstract>Disappearance of hyperdense middle cerebral artery sign (HMCAS) on non-contrast brain computed tomography (CT) scan is a reliable sign of arterial recanalization after intravenous (IV) thrombolysis for ischemic stroke. We aimed to assess whether stroke etiologic subtype may influence the rate of HMCAS disappearance and the clinical outcome after IV thrombolysis. We conducted a retrospective analysis of data prospectively collected from 1031 consecutive stroke patients treated with IV thrombolysis. Outcome measures were HMCAS disappearance on follow-up CT scan within 22–36 h of IV thrombolysis, neurologic improvement (NIH Stroke Scale [NIHSS] ≤4 points from baseline or NIHSS score of 0) at 7 days, and modified rankin scale (mRS) ≤1 at 3 months. Of 256 patients with HMCAS on admission CT scan, 125 had a cardioembolic stroke, 67 a stroke due to large-artery atherosclerosis (LAA), 58 a stroke of undetermined etiology, and six a stroke secondary to carotid artery dissection. HMCAS disappearance occurred in 145 (56.6 %) patients, neurologic improvement in 122 (55.0 %) patients, and mRS ≤1 in 64 (32.8 %) patients. Compared with cardioembolic stroke patients, patients with stroke due to LAA had lower odds ratios (OR) for HMCAS disappearance (OR 0.29, 95 % CI 0.15–0.58, p &lt; 0.001), neurologic improvement (OR 0.42, 95 % CI 0.22–0.82, p = 0.011), and mRS ≤1 (OR 0.18, 95 % CI 0.06–0.52, p = 0.002). No significant differences in outcome measures were found between cardioembolic strokes and strokes of undetermined etiology. This study suggests that stroke due to LAA is associated with lower rates of HMCAS disappearance, neurologic improvement, and mRS ≤1 after IV thrombolysis, compared with cardioembolic stroke.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27469539</pmid><doi>10.1007/s11239-016-1404-x</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-0609-3044</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0929-5305
ispartof Journal of thrombosis and thrombolysis, 2017, Vol.43 (1), p.86-90
issn 0929-5305
1573-742X
language eng
recordid cdi_proquest_miscellaneous_1868309205
source Springer Nature
subjects Administration, Intravenous
Adult
Aged
Cardiology
Female
Fibrinolytic Agents - administration & dosage
Fibrinolytic Agents - therapeutic use
Hematology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Middle Cerebral Artery - pathology
Recovery of Function
Retrospective Studies
Stroke - etiology
Thrombolytic Therapy - methods
Treatment Outcome
title Stroke etiologic subtype may influence the rate of hyperdense middle cerebral artery sign disappearance after intravenous thrombolysis
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T00%3A12%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Stroke%20etiologic%20subtype%20may%20influence%20the%20rate%20of%20hyperdense%20middle%20cerebral%20artery%20sign%20disappearance%20after%20intravenous%20thrombolysis&rft.jtitle=Journal%20of%20thrombosis%20and%20thrombolysis&rft.au=Forlivesi,%20Stefano&rft.date=2017&rft.volume=43&rft.issue=1&rft.spage=86&rft.epage=90&rft.pages=86-90&rft.issn=0929-5305&rft.eissn=1573-742X&rft_id=info:doi/10.1007/s11239-016-1404-x&rft_dat=%3Cproquest_cross%3E1868309205%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c405t-37000b0c9844e0fc4b25a4c64fe1b3f330997a0c7ac0cd4264d54763270764233%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1858001779&rft_id=info:pmid/27469539&rfr_iscdi=true