GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Abstract P512: Immune Correlates of Functional Outcome in Acute Ischemic Stroke (AIS) Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Stroke Vol. 52, No. Suppl_1 ( 2021-03)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. Suppl_1 ( 2021-03)
    Abstract: Introduction: Acute Ischemic Stroke (AIS) is one of the leading causes of disability and death in US. Although Endovascular Therapy (EVT) remains the mainstay therapy during acute phase for large vessel occlusions (LVOs), functional outcome varies among the treated patients. This ischemic injury results in an inflammatory response which plays an important role in the functional and neurological outcomes. We hypothesize that the early changes in the inflammatory response near the site of occlusion can be used as predictor of long-term neurofunctional decline Methods: AIS-LVO patients presenting to an academic comprehensive stroke center (CSC) within 24 hours from their last known well and undergoing EVT were included. Blood was collected proximal and distal to the thrombus during thrombectomy. Control samples were collected from the femoral artery and median cubital vein. Cytokine analysis and deep immune profiling was performed using a 20-parameter bead array and 13-parameter flow cytometer. Least Absolute Shrinkage and Selection Operator (LASSO) models were used for cell selection and correlation was evaluated for outcomes including mRS, NIHSS, MOCA and mortality, using R-software. Results: With 19 patients meeting the inclusion criteria, cytokine analysis revealed a significant increase in MMP and IFN-g, and decrease in GM-CSF, IL17, TNF-α, IL6, MIP-1a, and MIP-1b distal to clot. Flow cytometry analysis revealed a significant decrease in NK-T-cells, and CD8 T-cells counts and a relative increase in GM-CSF+ and IL17+ CD4 T-cells distal to clot. Immunological and neurological analysis revealed a correlation with CD4 + IFN-γ - IL10 + (r=0.7) & CD8 + IFN-γ - GMCSF + (0.6) with mRS, and CD4 + IFN-γ - IL10 + (r=0.7), CD4+ IFN-γ - IL17 + (r= -0.6), & CD8 + IFN-γ + IL17 + (r=0.7) cells with mortality. Conclusion: Our results indicate that local ischemia results in a hyperacute adaptive immune response at the site of occlusion. This immune response is predictive of functional outcome among AIS patients and is impactful in multiple ways, including the use of supportive therapy for patients with a poor functional trajectory and the use of immune-modulators at the site of ischemic injury.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.52.suppl_1.P512
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Abstract WMP88: Endovascular Versus Medical Treatment For Chronic Occlusion Of The Internal Carotid Artery: Systematic Review And Meta-analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Stroke Vol. 54, No. Suppl_1 ( 2023-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. Suppl_1 ( 2023-02)
    Abstract: Introduction: Chronic occlusion of the ICA (COICA) is an important cause of ischemic strokes. Evidence has showed that medical management (MM) alone is not sufficient for prevention of ischemic events. Carotid occlusion endovascular revascularization & stenting (COERS) is a promising technique, yet its safety and superiority to MM remain unclear. Objective: To pool and compare rates of safety and efficacy outcomes of COERS versus MM of COICA. Methods: We conducted a systematic search in Embase, Medline, and Web of Science for studies reporting short and long-term outcomes of symptomatic COICA patients who received MM and/or COERS. Main efficacy outcomes were successful recanalization and long-term recurrence of ischemic events. Safety outcomes for COERS were periprocedural ( & lt;30 days) events. We performed a meta-analysis of proportions for MM and COERS groups, using GLMM transformation and a random-effects model. Results: 11 studies contained data of COICA patients undergoing COERS, 3 studies of patients who received only MM, and 2 studies compared both arms; they provided data for 513 and 313 patients in the COERS and MM groups, respectively. The pooled recanalization rate after treatment with COERS was 75% (95% CI 0.67-0.82, PI 0.49-0.94, I 2 64%). Recurrence rates of ischemic events at long-term follow-up were 19% (95% CI 0.15-0.25, PI 0.11-0.32, I 2 25%) with MM, and 11% (95% CI 0.07-0.19, PI 0.02-0.42, I 2 2%) after COERS; comparison meta-analysis showed a similar non-significant trend (MM:24% vs. COERS:13%, OR 0.52, 95% CI 0.17-1.59, I 2 0%). The rate of periprocedural events in the COERS group were 2.3% (95% CI 0.012-0.045, I 2 0%) for stroke/TIA, and 2.1% (95% CI 0.011-0.038, I 2 0%) for any ICH. Conclusion: COERS is a feasible technique and a safe strategy for maximizing secondary stroke prevention for the treatment of symptomatic COICA. Still, further prospective trials to better define safety and efficacy boundaries are needed before starting a RCT.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.54.suppl_1.WMP88
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...