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- 저자 : Leonid Churilov (검색결과 2 건)
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Beisi Jiang,Leonid Churilov,Lasheta Kanesan,Richard Dowling,Peter Mitchell,Qiang Dong,Stephen Davis,Bernard Yan 대한뇌졸중학회 2017 Journal of stroke Vol.19 No.2
Background and Purpose Leptomeningeal collaterals maintain arterial perfusion in acute arterialocclusion but may fluctuate subject to arterial blood pressure (ABP). We aim to investigate therelationship between ABP and collaterals as assessed by computer tomography (CT) perfusion inacute ischemic stroke. Methods We retrospectively analyzed acute anterior circulation ischemic stroke patients with CTperfusion from 2009 to 2014. Collateral status using relative filling time delay (rFTD) determined bytime delay of collateral-derived contrast opacification within the Sylvian fissure, from 0 seconds tounlimited count. The data were analyzed by zero-inflated negative binomial regression modelincluding an appropriate interaction examining in the model in terms of occlusion location andonset-to-CT time (OCT). Results Two hundred and seventy patients were included. We found that increment of 10 mm Hgin BP, the odds that a patient would have rFTD equal to 0 seconds increased by 27.9% in systolicBP (SBP) (P=0.001), by 73.9% in diastolic BP (DBP) (P<0.001) and by 68.5% in mean BP (MBP)(P<0.001). For patients with rFTD not necessarily equal to 0 seconds, every 10 mm Hg increase inBP, there was a 7% decrease in expected count of seconds for rFTD in SBP (P=0.002), 10% decreasefor rFTD in DBP and 11% decrease for rFTD in MBP. The arterial occlusion location and OCT showedno significant interaction in the BP-rFTD relationship (P>0.05). Conclusions In acute ischemic stroke, higher ABP is possibly associated with improvedleptomeningeal collaterals as identified by decreased rFTD.
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Peter J. Mitchell,Bernard Yan,Leonid Churilov,Richard J. Dowling,Steven Bush,Thang Nguyen,Bruce C.V. Campbell,Geoffrey A. Donnan,Zhongrong Miao,Stephen M, Davis 대한뇌졸중학회 2022 Journal of stroke Vol.24 No.1
Background and Purpose The benefit regarding co-treatment with intravenous (IV) thrombolysis before mechanical thrombectomy in acute ischemic stroke with large vessel occlusion remains unclear. To test the hypothesis that clinical outcome of ischemic stroke patients with intracranial internal carotid artery, middle cerebral artery or basilar artery occlusion treated with direct endovascular thrombectomy within 4.5 hours will be non-inferior compared with that of standard bridging IV thrombolysis followed by endovascular thrombectomy. Methods To randomize 780 patients 1:1 to direct thrombectomy or bridging IV thrombolysis with thrombectomy. An international-multicenter prospective randomized open label blinded endpoint trial (PROBE) (ClincalTrials.gov identifier: NCT03494920). Results Primary endpoint is functional independence defined as modified Rankin Scale (mRS) 0–2 or return to baseline at 90 days. Secondary end points include ordinal mRS analysis, good angiographic reperfusion (modified Thrombolysis in Cerebral Infarction score [mTICI] 2b–3), safety endpoints include symptomatic intracerebral hemorrhage and death. Conclusions DIRECT-SAFE will provide unique information regarding the impact of direct thrombectomy in patients with large vessel occlusion, including patients with basilar artery occlusion, with comparison across different ethnic groups.
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