Quantitative Net Water Uptake as a Predictor of Functional Outcomes After Intravenous Thrombolysis in Acute Ischemic Stroke International Multicenter Observational Retrospective Study

Sigmund Freud PrivatUniversitat200 enrolled

Overview

While the effectiveness of intravenous thrombolysis (IVT) decreases over time, patients show considerable variability in how quickly their ischemic core progresses. Quantitative net water uptake (NWU) has emerged as a biomarker indicating blood-brain barrier disruption and may better reflect the "tissue clock" than time alone. Low NWU is associated with favorable outcomes, whereas high NWU predicts poor outcomes and futile recanalization. The study aims to determine whether NWU measured on initial non-contrast CT is a treatment effect modifier for the IVT therapy.

Study Type

OBSERVATIONAL

Enrollment

200

Conditions

Ischemic Stroke Thrombolysis

Interventions

No InterventionsOTHER

Not applicable as this is an observational, retrospective study.

Eligibility

Medical Language ↔ Plain English

Inclusion Criteria: * Acute ischemic stroke treated with intravenous thrombolysis * Imaging with non-contrast cranial CT on admission * Follow-up imaging with non-contrast cranial CT or MRI 12-24 hours after IVT * Final Infarct volume \> 5ml * ASPECTS available Exclusion Criteria: * Known use of oral anticoagulation (OAC) on admission * Preexisting ischemic infarction on admission non-contrast cranial CT * Patients with large vessel occlusion AIS who underwent mechanical thrombectomy * Low imaging quality precluding radiological measurements * Severe white matter lesions precluding radiological measurements * No ASPECTS

Outcomes

Primary Outcomes

Number of participants with functional independence (modified Rankin Scale score 0-1)

Functional independence defined as a modified Rankin Scale (mRS) score of 0-1 assessed at 90 days.

Time frame: at 90 days

Secondary Outcomes

Number of participants with symptomatic intracerebral hemorrhage

Symptomatic intracerebral hemorrhage (sICH) as defined by the European Cooperative Acute Stroke Study (ECASS) III criteria (i.e., an ICH associated with an increase of ≥4 points on the NIHSS or death where intracranial hemorrhage is the predominant cause of neurological deterioration).

Time frame: at 24 hours

Number of participants with intracerebral hemorrhage on follow-up brain imaging

Intracerebral hemorrhage detected on follow-up brain imaging performed within 24 hours after treatment.