Use of intravenous (IV) thrombolysis and intra-arterial (IA) recanalization treatment has been rapidly increasing, However, despite of the treatment, recanalization rates are 22.6 - 70% and only 30-50% of patients show meaningful clinical improvements. Mechanisms of futile recanalization may include 1) large ischemic core, 2) poor collateral, and 3) presence of comorbidity. In this regards, developing selection criteria using acute stroke imaging and comorbidity is warranted.
Investigators will recruit the consecutive acute stroke patients who received IV thrombolysis and/or IA recanalization treatment. This study will perform with prospective design to develop CT-based clot, core and collateral scores and a comorbidity index for selecting stroke patients who are at high risks by the treatment. Investigators will firstly establish the CT-based scores and comorbidity index using a pre-existing cohort database. Using these CT-based and comorbidity index, Investigators will validate them in a multi-center prospectively cohort. In addition, Investigators will assess the cost-effectiveness of selecting patients based on the comorbidity index.
- Brain CT imaging Other
Intervention Desc: Investigators will analyzed the CT image that was performed in patients with hyperacute stroke. The CT protocol includes CT thrombus, collateral, core images. Investigators also obtain detailed history and laboratory and imaging result for comorbidity. The comorbidity index protocol is based on the Charlson comorbidity index. ARM 1: Kind: Experimental Label: Acute ischemic stroke patients Description: Acute ischemic stroke patients who received intravenous (IV) thrombolysis and/or intra-arterial (IA) recanalization treatment
Acute ischemic stroke patients who received intravenous (IV) thrombolysis and/or intra-arterial (IA) recanalization treatment
|Type||Measure||Time Frame||Safety Issue|
|Primary||Modified Rankin scale scores||3 months after discharge day|
|Primary||Death||6 months after discharge day|
|Primary||National Institutes of Health Stroke Scale (NIHSS) scores||1 hr after IV rt-PA infusion|
|Primary||Recanalization rate||after 16 hrs thrombolytic treatments in MRA, CTA, or digital subtraction angiography (DSA)|
|Primary||Symptomatic hemorrhagic transformation rate||after 16 hrs thrombolytic treatments in MR or CT|
|Primary||asymptomatic hemorrhagic transformation rate||after 16 hrs thrombolysis in MR or CT|
- Yonsei University Lead