Prognostic value of cerebral venous outflow profiles for outcomes prediction following reperfusion therapy in acute ischemic stroke: a meta-analysis.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-09-01 Epub Date: 2025-07-08 DOI:10.1007/s00234-025-03688-w

Hesham Kelani, Mohamed R Abdelraouf, Shree Rath, Shrouk F Mohamed, Hazem Mohamed Salamah, Qasim Mehmood, Muhammad Ansab, Danisha Kumar, Ahmed Abd Elazim, Diana Greene-Chandos, Ketevan Berekashvili, Ambooj Tiwari, Volodymyr Vulkanov, David P Lerner, Eytan Raz

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引用次数: 0

Abstract

Background: Recent studies have suggested that favorable venous outflow (VO) may be a promising imaging biomarker to predict clinical outcomes following reperfusion therapy in patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO).

Methods: A comprehensive literature search was conducted in PubMed, Scopus, WOS, and Cochrane to identify studies that evaluated VO profiles, assessed using the Cortical Vein Opacification Score (COVES). The risk ratio (RR) and 95% confidence interval (CI) for the outcomes, including functional independence, assessed by modified rankin scale at 90 days (mRS 0-2), hemorrhagic infarction, parenchymal hematoma, 90-day mortality, intracranial hemorrhage (ICH), and symptomatic ICH (sICH), were calculated and analyzed using the 'meta' package in R version 4.4.1.

Results: A total of six studies encompassing 2249 patients were included. Patients with favorable VO had a higher likelihood of achieving functional independence at 90 days (RR = 2.15; 95% CI: 1.35, 3.42; p = 0.01) and a lower incidence of 90-day mortality (RR = 0.39; 95% CI: 0.30, 0.51; p < 0.01), parenchymal hematoma (RR = 0.36; 95% CI: 0.27, 0.47; p < 0.01). Furthermore, sICH was less frequent in patients with favorable VO (RR = 0.39; 95% CI: 0.17, 0.89; p = 0.03). However, hemorrhagic infarction and any ICH did not differ significantly between the two groups (p-values: 0.06 and 0.32, respectively).

Conclusion: VO is a promising imaging biomarker for predicting outcomes in patients with AIS-LVO following reperfusion therapy. Prospective clinical trials are warranted to investigate the predictive value of VO, assessed on multiphasic computed tomography angiography (CTA), as a prognostic marker in this patient population.

查看原文本刊更多论文

脑静脉流出曲线对急性缺血性卒中再灌注治疗后预后预测的预后价值：一项荟萃分析。

背景：最近的研究表明，有利静脉流出量（VO）可能是预测大血管闭塞（AIS-LVO）引起的急性缺血性卒中患者再灌注治疗后临床预后的一种有前景的成像生物标志物。方法：在PubMed、Scopus、WOS和Cochrane中进行全面的文献检索，以识别评估VO谱的研究，使用皮质静脉混浊评分（COVES）进行评估。使用R版本4.4.1中的“meta”软件包计算和分析结果的风险比（RR）和95%置信区间（CI），包括功能独立性，在90天（mRS 0-2），出血性梗死，实质血肿，90天死亡率，颅内出血（ICH）和症状性ICH （sICH）。结果：共纳入6项研究，共纳入2249例患者。VO良好的患者在90天实现功能独立的可能性更高(RR = 2.15；95% ci: 1.35, 3.42；p = 0.01)和较低的90天死亡率(RR = 0.39；95% ci: 0.30, 0.51；结论：VO是预测AIS-LVO患者再灌注治疗后预后的一种有前景的成像生物标志物。有必要进行前瞻性临床试验来研究VO的预测价值，通过多相计算机断层血管造影（CTA）评估，作为该患者群体的预后标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.