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Venous return in acute ischaemic stroke patients measured during computed tomography angiography of head and neck
Affiliations- Diagnostic Imaging Unit, University Hospital, Krakow, Poland
- Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland
- Chair of Neurology, Jagiellonian University, Medical College, Krakow, 31-501, Poland
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Abstract
Introduction: The aim of this study was to analyse the general features and usefulness of the time elapsed between the start of contrast agent infusion and its appearance in the aortic arch in acute ischaemic stroke patients subjected to baseline computed tomographic angiography. This is, to the best of our knowledge, the first study of this parameter in a clinical context. We will refer to it hereafter as ‘needle-to-aorta delay’ (NAD). Material and methods: The following were recorded: the time it took iodinated contrast media to reach the aorta, the site of occlusion, and automatic perfusion assessments of infarct and salvageable tissue volumes. Demographic data such as age and sex, comorbidities, and clinical factors including heart rate, blood pressure, time elapsed from symptom onset, initial stroke severity, and course of disease, were also assessed. Results: We analysed 252 cases of stroke. NAD correlated with tissue at risk volume, and was greater for patients with hypertension and atrial fibrillation. The observed time was significantly shorter with less favourable core-to-penumbra ratios. No link was found between NAD and either the rate of infarct progression or the long-term clinical result. Conclusions: Although no clinical benefit was proven as a result of measuring the time it took contrast media to reach the aorta, our study implies that not only is the brain subject to circulation, but it may also affect its functioning.
Abstract
Introduction: The aim of this study was to analyse the general features and usefulness of the time elapsed between the start of contrast agent infusion and its appearance in the aortic arch in acute ischaemic stroke patients subjected to baseline computed tomographic angiography. This is, to the best of our knowledge, the first study of this parameter in a clinical context. We will refer to it hereafter as ‘needle-to-aorta delay’ (NAD). Material and methods: The following were recorded: the time it took iodinated contrast media to reach the aorta, the site of occlusion, and automatic perfusion assessments of infarct and salvageable tissue volumes. Demographic data such as age and sex, comorbidities, and clinical factors including heart rate, blood pressure, time elapsed from symptom onset, initial stroke severity, and course of disease, were also assessed. Results: We analysed 252 cases of stroke. NAD correlated with tissue at risk volume, and was greater for patients with hypertension and atrial fibrillation. The observed time was significantly shorter with less favourable core-to-penumbra ratios. No link was found between NAD and either the rate of infarct progression or the long-term clinical result. Conclusions: Although no clinical benefit was proven as a result of measuring the time it took contrast media to reach the aorta, our study implies that not only is the brain subject to circulation, but it may also affect its functioning.
Keywords
stroke, brain perfusion, penumbra, cardiovascular system
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About this articleTitle
Venous return in acute ischaemic stroke patients measured during computed tomography angiography of head and neck
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
462-468
Published online
2021-09-01
Page views
6313
Article views/downloads
505
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2021;55(5):462-468.
Keywords
stroke
brain perfusion
penumbra
cardiovascular system
Authors
Bartłomiej Łasocha
Anna M. Grochowska
Paweł Wrona
Paweł J. Brzegowy
Roman Pułyk
Agnieszka Słowik
Paweł R. Latacz
Tadeusz J. Popiela
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