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Acute stroke imaging protocols and decision-making criteria for endovascular thrombectomy in acute ischemic stroke: a nationwide survey of thrombectomy-capable centers in Korea.

ABSTRACT:

SUBMITTER: Yun J

PROVIDER: S-EPMC12801524 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature

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Acute stroke imaging protocols and decision-making criteria for endovascular thrombectomy in acute ischemic stroke: a nationwide survey of thrombectomy-capable centers in Korea.

Yun Jaeseob J Park Hyungjong H Nam Hyo Suk HS Heo Ji Hoe JH Kim Young Dae YD

BMC neurology 20251208 1

BACKGROUND AND PURPOSE: Standardized imaging protocols and eligibility criteria are essential for optimizing endovascular thrombectomy (EVT) in acute ischemic stroke. This study investigated current imaging protocols and EVT eligibility criteria across different time windows in Korea. METHODS: This nationwide cross-sectional survey used a comprehensive 58-item electronic questionnaire was distributed to stroke neurologists, vascular neurosurgeons, and interventional neuroradiologists at 77 throm ...[more]

PMID: 41361255

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Project description:Background and purpose: Rodent models have demonstrated the key pathogenic role of the lectin pathway (LP) of complement activation in brain ischemic injury. Here we assessed the LP activation and its association with stroke severity and outcome in a well-characterized model of stroke mimicking mechanical thrombectomy in non-human primates. Methods: Transient middle cerebral artery occlusion was performed in Macaca fascicularis randomly allocated in cyclosporine A or placebo group. Neurological status was serially assessed. The occlusion lesion, the ischemic penumbra, the final lesion, the lesion growth between occlusion and day 7 as well as the blood-brain barrier permeability using quantitative transfer constant Ktrans ratio and inflammation by quantitative [11C]PK11195 imaging were assessed using positron emission tomography–magnetic resonance (PET-MRI) imaging. Functional residual LP-specific C3b deposition assay was performed in plasma. C3b/iC3b, mannose binding lectin (MBL), MBL associated serine proteases-2 (MASP-2) and interleukin-6 were measured in plasma, cerebrospinal fluid and brain homogenates. Brain tissue was used to perform immunofluorescence and confocal analyses (C3b/iC3b, MBL and MASP-2 and glycocalyx) as well as transcriptomic analysis. Results: Twenty-three subjects were included with a mean age of 6.7 +/- 0.5 years. LP residual activation in plasma collected late after recanalization was significantly decreased compared to baseline conditions. C3b/iC3b peaked at day 7 and this increase correlated with a more severe neurological deficit at day 1 and day 7, a larger final lesion and lesion growth volumes as well as a greater Ktrans ratio. C3b/iC3b, MBL and MASP-2 were found in microvascular thrombi at day 30. At this time point, 760 genes were differentially expressed within the lesion, including 13 LP-related genes. Conclusions: Our results support that the LP of complement activation is involved in thromboinflammation in a non-human primate model of stroke mimicking mechanical thrombectomy in humans.

Dataset Information

Acute stroke imaging protocols and decision-making criteria for endovascular thrombectomy in acute ischemic stroke: a nationwide survey of thrombectomy-capable centers in Korea.

Publications

Acute stroke imaging protocols and decision-making criteria for endovascular thrombectomy in acute ischemic stroke: a nationwide survey of thrombectomy-capable centers in Korea.

Similar Datasets

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