Efficacy and Safety of Timely Urgent Superficial Temporal Artery-to-Middle Cerebral Artery Bypass Surgery in Patients with Acute Ischemic Stroke: A Single-Institutional Prospective Study and a Pooled Analysis
DC Field | Value | Language |
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dc.contributor.author | Kim, Jang Hun | - |
dc.contributor.author | Yoon, Wonki | - |
dc.contributor.author | Kim, Chi Kyung | - |
dc.contributor.author | Roh, Haewon | - |
dc.contributor.author | Bae, Hee Jin | - |
dc.contributor.author | Kwon, Taek-Hyun | - |
dc.contributor.author | Suh, Sang-il | - |
dc.contributor.author | Oh, Kyungmi | - |
dc.contributor.author | Chong, Kyuha | - |
dc.date.accessioned | 2022-03-04T22:40:49Z | - |
dc.date.available | 2022-03-04T22:40:49Z | - |
dc.date.created | 2022-02-09 | - |
dc.date.issued | 2021-02 | - |
dc.identifier.issn | 1015-9770 | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/137791 | - |
dc.description.abstract | Background: Clinical outcome in patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) is not satisfactory if reperfusion treatment fails or is not tried. Aims: We aimed to assess the efficacy and safety of urgent superficial temporal-to-middle cerebral artery (STA-MCA) bypass surgery in selected patients. Methods: Patients who were diagnosed with LVO-induced AIS in the anterior circulation but had a failed intra-arterial thrombectomy (IAT) or were not tried due to IAT contraindications were prospectively enrolled. Timely urgent STA-MCA bypass surgery was performed if they showed perfusion-diffusion mismatch or symptom-diffusion mismatch in the acute phase of disease. Clinical and radiological data of these patients were assessed to demonstrate the safety and efficacy of urgent bypass procedures. A pooled analysis of published data on urgent bypass surgery in acute stroke patients was conducted and analyzed. Results: In 18 patients who underwent timely bypass, the National Institutes of Health Stroke Scale (NIHSS) score improved from 12.11 +/- 4.84 to 9.89 +/- 6.52, 1 week after surgery. Three-month and long-term (9.72 +/- 5.00 months) favorable outcomes (modified Rankin Scale [mRS] scores 0-2) were achieved in 50 and 75% of the patients, respectively. The pooled analysis (117 patients from 10 articles, including ours) identified favorable mRS scores in 71.79% patients at 3 months. A significant NIHSS score improvement from 11.51 +/- 4.89 to 7.59 +/- 5.50 was observed after surgery with significance. Major complications occurred in 3 patients (2.6%, 3/117) without mortality. Conclusions: Urgent STA-MCA bypass surgery can be regarded as a safe optional treatment to prevent cerebral infarct expansion and to improve clinical and radiological outcomes in highly selected patients. (c) 2021 S. Karger AG, Basel | - |
dc.language | English | - |
dc.language.iso | en | - |
dc.publisher | KARGER | - |
dc.subject | EXTRACRANIAL-INTRACRANIAL BYPASS | - |
dc.subject | EARLY CT SCORE | - |
dc.subject | TISSUE | - |
dc.title | Efficacy and Safety of Timely Urgent Superficial Temporal Artery-to-Middle Cerebral Artery Bypass Surgery in Patients with Acute Ischemic Stroke: A Single-Institutional Prospective Study and a Pooled Analysis | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Yoon, Wonki | - |
dc.contributor.affiliatedAuthor | Kim, Chi Kyung | - |
dc.contributor.affiliatedAuthor | Suh, Sang-il | - |
dc.identifier.doi | 10.1159/000512106 | - |
dc.identifier.scopusid | 2-s2.0-85099532630 | - |
dc.identifier.wosid | 000607690800001 | - |
dc.identifier.bibliographicCitation | CEREBROVASCULAR DISEASES, v.50, no.1, pp.34 - 45 | - |
dc.relation.isPartOf | CEREBROVASCULAR DISEASES | - |
dc.citation.title | CEREBROVASCULAR DISEASES | - |
dc.citation.volume | 50 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 34 | - |
dc.citation.endPage | 45 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Neurosciences & Neurology | - |
dc.relation.journalResearchArea | Cardiovascular System & Cardiology | - |
dc.relation.journalWebOfScienceCategory | Clinical Neurology | - |
dc.relation.journalWebOfScienceCategory | Peripheral Vascular Disease | - |
dc.subject.keywordPlus | EARLY CT SCORE | - |
dc.subject.keywordPlus | EXTRACRANIAL-INTRACRANIAL BYPASS | - |
dc.subject.keywordPlus | TISSUE | - |
dc.subject.keywordAuthor | Acute ischemic stroke | - |
dc.subject.keywordAuthor | Acute stroke intervention | - |
dc.subject.keywordAuthor | Acute stroke treatment | - |
dc.subject.keywordAuthor | Bypass surgery | - |
dc.subject.keywordAuthor | Stroke surgery | - |
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