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Master Thesis

Devenir du mismatch perfusion/diffusion chez les patients non recanalisés après thrombolyse

Abstract : Our objective was to determine the rate of salvaged mismatch PWI/DWI in non recanalizers patients and to identify factors influencing the fate of this critically hypoperfused tissue. Methods: We included 57 patients with anterior circulation acute ischemic stroke without vessel recanalization despite intravenous thrombolysis. Using voxel-­-based analysis of coregistrated MR images before and 24 hours after treatment, salvaged mismatch was defined as the initial PWI/DWI mismatch that did not overlap with final infarct. Mean Tmax values were compared between salvaged and infarcted mismatch areas. We also searched an association between cardiovascular risk factors, pre-­-thrombolysis clinical factors and percentage of salvaged mismatch. Results: Using Tmax>6 seconds, 60.4% [40.0-­-83.8] of the PWI/DWI mismatch escaped from infarction. Salvaged mismatch was still sizeable for Tmax>8 s (50.5% [30.1-­-80.0]) and for Tmax>10s (41.1% [22.2-­-70.3]). Salvaged mismatch was initially less severely hypoperfused than the infarcted mismatch (Tmax: 8.3sec [7.8-­-9.1] vs 10.2 [8.9-­-11.4], P<0.001). Diabetics had a lower percentage of salvaged mismatch than non-­-diabetics (41.7 vs 62.9%, P=0.046). Conclusion: Large fraction of PWI/DWI mismatch do not proceed to infarction even for stringent Tmax thresholds in thrombolysed non recanalizers.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01251776
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Submitted on : Wednesday, January 6, 2016 - 4:50:06 PM
Last modification on : Friday, March 27, 2020 - 2:53:15 AM
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  • HAL Id : dumas-01251776, version 1

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Jonathan Dbjay. Devenir du mismatch perfusion/diffusion chez les patients non recanalisés après thrombolyse . Médecine humaine et pathologie. 2015. ⟨dumas-01251776⟩

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