@article{14ae5c0095a647cab844ebb7bb04bc47,
title = "Value of infarct location in the prediction of functional outcome in patients with an anterior large vessel occlusion: results from the HERMES study",
abstract = "Purpose: Follow-up infarct volume (FIV) is moderately associated with functional outcome. We hypothesized that accounting for infarct location would strengthen the association of FIV with functional outcome. Methods: We included 252 patients from the HERMES collaboration with follow-up diffusion weighted imaging. Patients received endovascular treatment combined with best medical management (n = 52%) versus best medical management alone (n = 48%). FIV was quantified in low, moderate and high modified Rankin Scale (mRS)-relevant regions. We used binary logistic regression to study the relation between the total, high, moderate or low mRS-relevant FIVs and favorable outcome (mRS < 2) after 90 days. The strength of association was evaluated using the c-statistic. Results: Small lesions only occupied high mRS-relevant brain regions. Lesions additionally occupied lower mRS-relevant brain regions if FIV expanded. Higher FIV was associated with a higher risk of unfavorable outcome, as were volumes of tissue with low, moderate and high mRS relevance. In multivariable modeling, only the volume of high mRS-relevant infarct was significantly associated with favorable outcome. The c-statistic was highest (0.76) for the models that included high mRS-relevant FIV or the combination of high, moderate and low mRS-relevant FIV but was not significantly different from the model that included only total FIV (0.75). Conclusion: This study confirms the association of FIV and unfavorable functional outcome but showed no strengthened association if lesion location was taken into account.",
keywords = "Acute ischemic stroke, Diffusion weighted imaging, Follow-up infarct location, Functional outcome",
author = "Tolhuisen, {Manon L.} and Marielle Ernst and Boers, {Anne M. M.} and Scott Brown and Beenen, {Ludo F. M.} and Francis Guillemin and Roos, {Yvo B. W. E. M.} and Saver, {Jeffrey L.} and {van Oostenbrugge}, Robert and Demchuck, {Andrew M.} and {van Zwam}, Wim and Jovin, {Tudor G.} and Berkhemer, {Olvert A.} and Muir, {Keith W.} and Serge Bracard and Campbell, {Bruce C. V.} and {van der Lugt}, Aad and Phill White and Hill, {Michael D.} and Dippel, {Diederik W. J.} and Mitchell, {Peter J.} and Mayank Goyal and Caan, {Matthan W. A.} and Marquering, {Henk A.} and Majoie, {Charles B. L. M.}",
note = "Funding Information: The CONTRAST consortium is supported by Netherlands Cardiovascular Research Initiative (CVON), an initiative of the Dutch Heart Foundation, by the Brain Foundation Netherlands, Medtronic and Cerenovus. Funding Information: The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Dr. Majoie reports grants from CVON/Dutch Heart Foundation, TWIN Foundation, European Commission, Dutch Health Evaluation program and Stryker outside the submitted work (paid to institution) and is shareholder of Nico.lab International Ltd. A.van der Lugt and D.W.J.Dippel are the recipients of unrestricted grants from Dutch Heart Foundation, Dutch Brain Foundation, The Netherlands Organisation for Health Research and Development, Health Holland Top Sector Life Science, Stryker, Medtronic, Penumbra Inc. and Cerenovus for the conduct of trials of acute treatment for stroke. Dr. Caan is shareholder of Nico.lab International Ltd. Dr. H.A. Marquering is co-founder and shareholder of Nico.lab International Ltd. Dr. Saver is an employee of the University of California. The University of California has patent rights in retrieval devices for stroke. The University of California Regents received payments on the basis of clinical trial contracts for the number of subjects enrolled in multicenter clinical trials sponsored by Medtronic, Stryker, Cerenovus and Rapid Medical; Dr. Saver served as an unpaid site investigator under these contracts. Dr. Saver has received contracted hourly payments and travel reimbursement for services as a scientific consultant advising on rigorous trial design and conduct to Medtronic, Stryker and Cerenovus. Dr. Saver has received contracted stock options for services as a scientific consultant advising on rigorous trial design and conduct to Rapid Medical. Prof White declares institutional unrestricted educational grants from Medtronic, Penumbra and Stryker, institutional grant from Microvention and personal consultancy work for Microvention. Prof K Muir has received fees for advisory boards or speaking from Boehringer Ingelheim, Biogen, Bayer, Daiichi Sankyo and ReNeuron, and receives institutional support from Boehringer Ingelheim for the ATTEST-2 trial. Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
doi = "https://doi.org/10.1007/s00234-021-02784-x",
language = "English",
journal = "Neuroradiology",
issn = "0028-3940",
publisher = "Springer Verlag",
}