Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;28(10):1568-1575.
doi: 10.1111/cns.13888. Epub 2022 Jun 16.

Elevated pulsatility index is associated with poor functional outcome in stroke patients treated with thrombectomy: A retrospective cohort study

Wenbo Zhao  1   2 , Ran Liu  3 , Wantong Yu  1 , Longfei Wu  1 , Chuanjie Wu  1 , Chuanhui Li  4 , Sijie Li  2 , Jian Chen  4 , Haiqing Song  1 , Yang Hua  3 , Qingfeng Ma  1 , Xunming Ji  4
Affiliations

Elevated pulsatility index is associated with poor functional outcome in stroke patients treated with thrombectomy: A retrospective cohort study

Wenbo Zhao et al. CNS Neurosci Ther. 2022 Oct.

Abstract

Aims: To evaluate pulsatility index (PI) in patients with acute ischemic stroke (AIS) who underwent endovascular thrombectomy (EVT).

Methods: Patients were retrospectively recruited if their stroke were secondary to middle cerebral artery (MCA) occlusion and achieved full recanalization after EVT. Transcranial Doppler was performed within 24-hour post-EVT. The primary outcome was correlation between the MCA-PI on the affected side and 3-month functional outcome, with modified Rankin scale (mRS) ≥5 indicated extremely poor functional outcomes.

Results: Totally, 170 patients were included. High MCA-PI was positively related to the 3-month mRS score (r = 0.288, p < 0.001). The highest quartile of the MCA-PI was associated with a high incidence of extremely poor functional outcomes (adjusted OR, 13.33; 95% CI, 2.65-67.17; adjusted p = 0.002) after adjusting for confounding factors. The predictive capacity of the MCA-PI for extremely poor functional outcomes was good (area under the curve, 0.755; 95% CI, 0.655-0.854; p < 0.001), and its cutoff value for predicting extremely poor outcomes was 1.04, with a sensitivity of 65.6% and specificity of 78.3%.

Conclusion: The MCA-PI on the affected side is a prognostic biomarker in patients who have undergone stroke thrombectomy. An elevated MCA-PI may be prognostically valuable for predicting extremely poor functional outcomes.

Keywords: acute ischemic stroke; endovascular thrombectomy; microcirculation no-reperfusion; pulsatility index; “no-reflow” phenomenon.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Correlation of pulsatility index and functional outcomes. Correlation of the affected middle cerebral artery (MCA) pulsatility index (PI) with 90‐day functional outcomes assessed by modified Rankin scale (mRS). A total of 170 participants were included, and r = 0.288 with p < 0.001
FIGURE 2
FIGURE 2
Receiver operating characteristic curve for extremely poor functional outcomes 3 months after thrombectomy demonstrating area under cure was 0.755 (95% confidence interval, 0.655–0.854) with a p value < 0.001. The optimal cutoff point of affected middle cerebral artery pulsatility index for predicting poor outcome was 1.04, with sensitivity of 0.656 and specificity of 0.783
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large‐vessel ischaemic stroke: a meta‐analysis of individual patient data from five randomised trials. Lancet. 2016;387:1723‐1731. - PubMed
    1. Leng T, Xiong Z‐G. Treatment for ischemic stroke: from thrombolysis to thrombectomy and remaining challenges. Brain Circ. 2019;5:8‐11. doi:10.4103/bc.bc_36_18 Review Article. - DOI - PMC - PubMed
    1. Ji X. Forward thinking in stroke treatment: advances in cerebrovascular reperfusion and neurorehabilitation. Brain Circ. 2015;1:1‐2. doi:10.4103/2394-8108.166347 Editorial. - DOI
    1. Zhao W, Wu C, Dornbos D III, et al. Multiphase adjuvant neuroprotection: a novel paradigm for improving acute ischemic stroke outcomes. Brain Circ. 2020;6:11‐18. doi:10.4103/bc.bc_58_19 Review Article. - DOI - PMC - PubMed
    1. Faizy TD, Kabiri R, Christensen S, et al. Perfusion imaging‐based tissue‐level collaterals predict ischemic lesion net water uptake in patients with acute ischemic stroke and large vessel occlusion. J Cereb Blood Flow Metab. 2021;41:2067‐2075. doi:10.1177/0271678x21992200 - DOI - PMC - PubMed

Publication types

MeSH terms