@article{9dad1129d324492d8908f029e5382ba6,
title = "Role of intravenous alteplase on late lesion growth and clinical outcome after stroke treatment",
abstract = "Several acute ischemic stroke mechanisms that cause lesion growth continue after treatment which is detrimental to long-term clinical outcome. The potential role of intravenous alteplase treatment (IVT), a standard in stroke care, in cessing the physiological processes causing post-treatment lesion development is understudied. We analyzed patients from the MR CLEAN-NO IV trial with good quality 24-hour and 1-week follow-up Non-Contrast CT scans. We delineated hypo- and hyper-dense regions on the scans as lesion. We performed univariable logistic and linear regression to estimate the influence of IVT on the presence (growth > 0 ml) and extent of late lesion growth. The association between late lesion growth and mRS was assessed using ordinal logistic regression. Interaction analysis was performed to evaluate the influence of IVT on this association. Of the 63/116 were randomized to included patients, IVT. Median growth was 8.4(-0.88-26) ml. IVT was not significantly associated with the presence (OR: 1.24 (0.57-2.74, p = 0.59) or extent (beta = 5.1(-8.8-19), p = 0.47) of growth. Late lesion growth was associated with worse clinical outcome (aOR: 0.85(0.76-0.95), p < 0.01; per 10 ml). IVT did not influence this association (p = 0.18). We did not find evidence that IVT influences late lesion growth or the relationship between growth and worse clinical outcome. Therapies to reduce lesion development are necessary.",
keywords = "Brain edema, intracranial, intracerebral hemorrhage, neurovascular coupling, TPA, acute stroke, ENDOVASCULAR THERAPY, INFARCT GROWTH, FINAL INFARCT, RECANALIZATION, REPERFUSION, VOLUME",
author = "P. Konduri and F. Cavalcante and {van Voorst}, H. and L. Rinkel and M. Kappelhof and {van Kranendonk}, K. and K. Treurniet and B. Emmer and J. Coutinho and L. Wolff and J. Hofmeijer and M. Uyttenboogaart and {van Zwam}, W. and Y. Roos and C. Majoie and H. Marquering and {MR CLEAN-NO IV Investigators}",
note = "Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Ms. Konduri was funded by INSIST ( www.insist-h2020.eu ): a European Union{\textquoteright}s Horizon 2020 research and innovation programme (Grant Agreement Number: 777072) and the RadPath AI project (2021191). Dr. Roos is shareholder of Nico.lab. Dr. Coutinho reports research support from Medtronic (paid to institution). Dr. van Zwam reports speaker fees from Stryker and Cerenovus (paid to the institution). Dr. Majoie reports grants from CVON/Dutch Heart Foundation and Stryker (related and paid to institution), and TWIN Foundation, European Commission, Health Evaluation Netherlands (outside the submitted work and paid to institution); and is shareholder of Nico.lab. Dr. Marquering is cofounder and shareholder of Nico.lab. All other authors have nothing to disclose. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: MR CLEAN-NO IV was funded through the CONTRAST consortium, which acknowledges the support from the Netherlands Cardiovascular Research Initiative, an initiative of the Dutch Heart Foundation (CVON2015-01: CONTRAST), and from the Brain Foundation Netherlands (HA2015.01.06). The collaboration project is additionally financed by the Ministry of Economic Affairs by means of the PPP Allowance made available by the Top Sector Life Sciences & Health to stimulate public-private partnerships (LSHM17016). This work was funded in part through unrestricted funding by Stryker, Medtronic and Cerenovus. The funding sources were not involved in study design, monitoring, data collection, statistical analyses, interpretation of results, or manuscript writing. This sub-study was also funded by INSIST ( www.insist-h2020.eu ): a European Union{\textquoteright}s Horizon 2020 research and innovation program (Grant Agreement Number: 777072). Publisher Copyright: {\textcopyright} The Author(s) 2023.",
year = "2023",
month = nov,
doi = "10.1177/0271678X231167755",
language = "English",
volume = "43",
pages = "116--125",
journal = "Journal of Cerebral Blood Flow and Metabolism",
issn = "0271-678X",
publisher = "SAGE Publications Inc.",
number = "2_SUPPL",
}