Use of intravenous (IV) thrombolysis and intra-arterial (IA) recanalization treatment has been rapidly increasing, However, despite of the treatment, recanalization rates are 22.6 - 70% and only 30-50% of patients show meaningful clinical improvements. Mechanisms of futile recanalization may include 1) large ischemic core, 2) poor collateral, and 3) presence of comorbidity. In this regards, developing selection criteria using acute stroke imaging and comorbidity is warranted. Investigators will recruit the consecutive acute stroke patients who received IV thrombolysis and/or IA recanalization treatment. This study will perform with prospective design to develop CT-based clot, core and collateral scores and a comorbidity index for selecting stroke patients who are at high risks by the treatment. Investigators will firstly establish the CT-based scores and comorbidity index using a pre-existing cohort database. Using these CT-based and comorbidity index, Investigators will validate them in a multi-center prospectively cohort. In addition, Investigators will assess the cost-effectiveness of selecting patients based on the comorbidity index.
Study Type
OBSERVATIONAL
Enrollment
1,359
Investigators will analyzed the CT image that was performed in patients with hyperacute stroke. The CT protocol includes CT thrombus, collateral, core images. Investigators also obtain detailed history and laboratory and imaging result for comorbidity. The comorbidity index protocol is based on the Charlson comorbidity index.
Department of Neurology, Yonsei University College of Medicine
Seoul, South Korea
Modified Rankin scale scores
Time frame: 3 months after discharge day
Death
Time frame: 6 months after discharge day
National Institutes of Health Stroke Scale (NIHSS) scores
Time frame: 1 hr after IV rt-PA infusion
Recanalization rate
Time frame: after 16 hrs thrombolytic treatments in MRA, CTA, or digital subtraction angiography (DSA)
Recanalization rate
Time frame: after 24 hrs thrombolytic treatments in MRA, CTA, or digital subtraction angiography (DSA)
Recanalization rate
Time frame: after 32 hrs thrombolytic treatments in MRA, CTA, or digital subtraction angiography (DSA)
Symptomatic hemorrhagic transformation rate
Time frame: after 16 hrs thrombolytic treatments in MR or CT
Symptomatic hemorrhagic transformation rate
Time frame: after 24 hrs thrombolytic treatments in MR or CT
Symptomatic hemorrhagic transformation rate
Time frame: after 32 hrs thrombolytic treatments in MR or CT
asymptomatic hemorrhagic transformation rate
Time frame: after 16 hrs thrombolysis in MR or CT
asymptomatic hemorrhagic transformation rate
Time frame: after 24 hrs thrombolysis in MR or CT
asymptomatic hemorrhagic transformation rate
Time frame: after 32 hrs thrombolysis in MR or CT
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