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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Stroke
2017 ; 19
(2
): 222-228
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English Wikipedia
Blood Pressure May Be Associated with Arterial Collateralization in Anterior
Circulation Ischemic Stroke before Acute Reperfusion Therapy
#MMPMID28460496
Jiang B
; Churilov L
; Kanesan L
; Dowling R
; Mitchell P
; Dong Q
; Davis S
; Yan B
J Stroke
2017[May]; 19
(2
): 222-228
PMID28460496
show ga
BACKGROUND AND PURPOSE: Leptomeningeal collaterals maintain arterial perfusion in
acute arterial occlusion but may fluctuate subject to arterial blood pressure
(ABP). We aim to investigate the relationship between ABP and collaterals as
assessed by computer tomography (CT) perfusion in acute ischemic stroke. METHODS:
We retrospectively analyzed acute anterior circulation ischemic stroke patients
with CT perfusion from 2009 to 2014. Collateral status using relative filling
time delay (rFTD) determined by time delay of collateral-derived contrast
opacification within the Sylvian fissure, from 0 seconds to unlimited count. The
data were analyzed by zero-inflated negative binomial regression model including
an appropriate interaction examining in the model in terms of occlusion location
and onset-to-CT time (OCT). RESULTS: Two hundred and seventy patients were
included. We found that increment of 10 mm Hg in BP, the odds that a patient
would have rFTD equal to 0 seconds increased by 27.9% in systolic BP (SBP)
(p=0.001), by 73.9% in diastolic BP (DBP) (p<0.001) and by 68.5% in mean BP (MBP)
(p<0.001). For patients with rFTD not necessarily equal to 0 seconds, every 10 mm
Hg increase in BP, there was a 7% decrease in expected count of seconds for rFTD
in SBP (p=0.002), 10% decrease for rFTD in DBP and 11% decrease for rFTD in MBP.
The arterial occlusion location and OCT showed no significant interaction in the
BP-rFTD relationship (p>0.05). CONCLUSIONS: In acute ischemic stroke, higher ABP
is possibly associated with improved leptomeningeal collaterals as identified by
decreased rFTD.