Log In

Forgot Password?

OR

Not a member? Continue as a nonmember.

Become a Member

By becoming a member of the AAN, you can receive exclusive information to help you at every stage of your career. Benefits include:

Join Now See All Benefits

Loading... please wait

Abstract Details

Hypoperfusion intensity ratio is correlated to infarct growth rate parameters when modelled as a logistic growth function
Cerebrovascular Disease and Interventional Neurology
P6 - Poster Session 6 (5:30 PM-6:30 PM)
6-022

Understanding IGR in patients with Acute Ischemic stroke (AIS) due to Large Vessel Occlusion (LVO) may allow for individualized treatment to improve neurological recovery. Other IGR models, like slow vs fast progressor classification, may be too broad. Additionally, animal studies have successfully modelled IGR as a logistic growth function and found its parameters are dependent on collateral circulation. We present the first logistic model for IGR in human patients.

To model infarct growth rate as a logistic growth function and determine its association to hypoperfusion intensity ratio (HIR)

This a secondary analysis of a retrospective cohort of AIS patients due to anterior circulation LVO that underwent successful endovascular therapy in two comprehensive stroke centers. Two time measures were used: from stroke onset to CT perfusion and from this to reperfusion.  Final infarct volume was measured with DWI-MRI within 24 hours after EVT. IGR was modelled as a logistic growth function with a maximum infarct volume parameter (Vmax) and infarct growth rate parameter (r). These were estimated for each patient. To assess correlation to HIR, we used Pearson’s correlation coefficient.

We included 34 patients; 24 classified as having good collaterals (HIR<0.4) and 10 as having poor collaterals (HIR>0.4). Median age was 72.5 (IQR 56.25 - 83.0) and 50% were male. Median baseline NIHSS was 16 (IQR 12.5 – 18). None were different between groups. Vmax was 51.5 (37.6 in good HIR vs 59.6 in poor HIR, p=0.322), while r was 0.024 (0.031 vs 0.024, respectively, p=0.724). HIR’s Pearson’s coefficient was 0.455 (0.13 – 0.68, p=0.006) for Vmax, while it was 0.11 (-0.22 – 0.43, p=0.5076) for r.

IGR can be modelled as a logistic growth function with parameters dependent on multiple factors. When modelling IGR, we found that HIR was associated with infarct maximum growth, but not growth rate.

Authors/Disclosures
Marco Moises Malaga, MD (University of California in San Francisco)
PRESENTER
Mr. Malaga has nothing to disclose.
Milagros Galecio-Castillo, MD (University of Iowa Hospitals and Clinics) Dr. Galecio-Castillo has nothing to disclose.
Darko Ernesto Quispe Orozco, MD (TTUHSC-SOM, Lubbock; Neurology Dept.) Dr. Quispe Orozco has nothing to disclose.
Juan A. Vivanco-Suarez, MD Mr. Vivanco-Suarez has nothing to disclose.
Aaron Eduardo Rodriguez-Calienes (University of Iowa Hospitals and Clinics) Dr. Rodriguez-Calienes has nothing to disclose.
Cynthia Zevallos Cynthia Zevallos has nothing to disclose.
Jessica Kobsa (Yale University) Ms. Kobsa has nothing to disclose.
Ayush Prasad (Yale School of Medicine & Yale - New Haven Hospital) Mr. Prasad has nothing to disclose.
Mudassir Farooqui, MD Dr. Farooqui has nothing to disclose.
Nils Petersen, MD (Yale University) Dr. Petersen has received research support from NIH.
Santiago Ortega Gutierrez, MD (University of Iowa) Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for stryker. Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for medtronic. Dr. Ortega Gutierrez has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for microvention. The institution of Dr. Ortega Gutierrez has received research support from stryker. The institution of Dr. Ortega Gutierrez has received research support from IschemiaView. The institution of Dr. Ortega Gutierrez has received research support from Medtronic. The institution of Dr. Ortega Gutierrez has received research support from Methinks. The institution of Dr. Ortega Gutierrez has received research support from NIH.