萩原 信司
Department School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine Position Assistant Professor |
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Article types | Original article |
Language | English |
Peer review | Peer reviewed |
Title | Preoperative plasma D-dimer level may be predictive for success of cerebral reperfusion and outcome after emergency mechanical thrombectomy for intracranial large vessel occlusion |
Journal | Formal name:Journal of Clinical Neuroscience Abbreviation:J Clin Neurosci ISSN code:0967-5868 |
Domestic / Foregin | Foregin |
Volume, Issue, Page | 97,pp.75-81 |
Author and coauthor | Ohbuchi Hidenori†*, Kanazawa Ryuzaburo, Hagiwara Shinji, Arai Naoyuki, Takahashi Yuichi, Kubota Yuichi, Chernov Mikhail, Kasuya Hidetoshi |
Authorship | 2nd author |
Publication date | 2022 |
Summary | Presented retrospective analysis evaluated whether preoperative plasma D-dimer level may predict the success of cerebral reperfusion and outcome after emergency mechanical thrombectomy (MT) for intracranial large vessel occlusion (ILVO). Study cohort comprised 121 patients (mean age, 76 ± 12 years) from two participating centers. ILVO mostly affected the M1 segment (48 cases) and internal carotid artery (ICA; 37 cases). Mean preoperative National Institutes of Health Stroke Scale (NIHSS) score was 18 ± 8. Mean preoperative plasma D-dimer level was 4.4 ± 6.6 μg/ml. In 88 patients (73%) MT resulted in successful cerebral reperfusion. Multivariate analysis revealed independent associations of non-successful cerebral reperfusion with preoperative plasma D-dimer level > 6.7 μg/ml (P = 0.0021), location of ILVO other than ICA (P = 0.0056), and prolonged antiplatelet or anticoagulant therapy before stroke onset (P = 0.0172). Plasma D-dimer level ≤ 6.7 μg/ml predicted successful cerebral reperfusion with 0.91 sensitivity and 0.36 specificity. In 39 patients (32%) treatment resulted in favorable outcome. Multivariate analysis revealed independent associations of the unfavorable outcome with non-successful cerebral reperfusion after MT (P = 0.0005), preoperative plasma D-dimer level > 1.9 μg/ml (P = 0.0131), higher preoperative NIHSS score (P = 0.0171), and chronic arterial hypertension before stroke onset (P = 0.0254). Plasma D-dimer level ≤ 1.9 μg/ml predicted favorable outcome with 0.64 sensitivity and 0.62 specificity. In conclusion, preoperative plasma D-dimer level may be predictive for success of cerebral reperfusion and outcome after emergency MT for ILVO, which may be potentially helpful for prediction of prognosis in selected treatment candidates. |
DOI | 10.1016/j.jocn.2021.12.034 |