Abstract:
BACKGROUND AND PURPOSE:The best method of selecting endarterectomy candidates for cerebral angiography is controversial. Carotid duplex ultrasound (CDUS) is widely used, but its performance varies across institutions. The clinical utility of CDUS could be improved with test criteria based on patient outcome rather than test accuracy. METHODS:In 155 carotid bifurcations studied by CDUS and cerebral angiography, the degree of angiographic stenosis was measured by a reader, blinded to CDUS, using the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method. We calculated accuracy, sensitivity, and specificity for predicting > or = 70% angiographic carotid stenosis of different peak systolic frequencies (PSF) measured by CDUS and generated a receiver operator characteristic (ROC) curve. We used NASCET outcome data and published data on angiographic complications to define relative "costs" of false-positive and false-negative CDUS, and we determined the point on the ROC curve representing the CDUS criterion with the highest clinical utility. We compared projected morbidity and mortality rates for 1000 hypothetical endarterectomy candidates resulting from the use of the most accurate CDUS criterion versus the CDUS criterion with the highest clinical utility by ROC analysis. RESULTS:While PSF > or = 8 kHz had the highest CDUS accuracy (93%), its projected stroke and death rate due to CDUS error was 10.4/1000. On the other hand, PSF > or = 7 kHz, defined by ROC analysis to have the highest clinical utility, had a lower morbidity and mortality rate of 6.8/1000. CONCLUSIONS:The use of ROC analysis and available outcome data can improve the performance of CDUS in selecting endarterectomy candidates for cerebral angiography.
journal_name
Strokejournal_title
Strokeauthors
Wilterdink JL,Feldmann E,Easton JD,Ward Rdoi
10.1161/01.str.27.6.1094subject
Has Abstractpub_date
1996-06-01 00:00:00pages
1094-8issue
6eissn
0039-2499issn
1524-4628journal_volume
27pub_type
杂志文章相关文献
STROKE文献大全abstract::Background and Purpose- Hemispheric stroke studies associating lateropulsion (pusher syndrome) with the location of brain lesions have had mixed results from small, unmatched samples. This study was designed to determine whether lateropulsion localizes to specific brain regions across patients with stroke using a case...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.118.023445
更新日期:2019-05-01 00:00:00
abstract::Acute cerebral circulatory changes following experimental cerebral hemorrhage were investigated in eight cats. The cerebral hemorrhage was produced in the right basal ganglia by introducing arterial blood via a thin catheter, using the systemic arterial blood pressure of the cat as a driving force. Local cerebral bloo...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.19.8.991
更新日期:1988-08-01 00:00:00
abstract::To elucidate the connection between blood flow and the localized genesis and development of atherosclerosis and thrombosis at the human carotid artery bifurcation, detailed studies of the flow patterns and distributions of fluid velocity and wall shear rate in this region were carried out using a transparent segment o...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.15.1.50
更新日期:1984-01-01 00:00:00
abstract:PURPOSE:To investigate differences between symptomatic and asymptomatic retinal embolism regarding the frequency and source of cerebral microemboli. METHODS:Thirty-seven patients with transient monocular blindness or retinal infarction and 27 patients (29 eyes) with asymptomatic retinal embolism were prospectively enr...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000125009.05353.7c
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:When carotid artery tandem lesions are present, the benefits of carotid endarterectomy (CEA) to reduce recurrent stroke remain uncertain. The present retrospective cohort study aimed to determine the clinical outcomes of CEA for carotid artery tandem stenosis that was diagnosed by contrast-enhanc...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.114.007181
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Cerebral amyloid angiopathy (CAA) occasionally coexists with cerebral vasculitis. An immune system may influence deposition or degradation of the amyloid in cerebral blood vessels. The purpose of this study was to elucidate immune reactions associated with CAA. METHODS:In 11 elderly patients wit...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.27.7.1155
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The Mechanical Embolus Removal in Cerebral Ischemia (MERCI) and Multi MERCI trials evaluated the safety and efficacy of thrombectomy in the treatment of intracranial arterial occlusions within 8 hours of symptom onset. We sought to determine the predictors of clinical and angiographic outcomes in...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.109.561431
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:In the United States, stroke mortality is higher in the south than in other regions. Hypertension is the main risk factor for stroke among older adults; however, few studies have examined group-specific regional and urbanization differences in hypertension prevalence. METHODS:Data from the Third National He...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.31.1.19
更新日期:2000-01-01 00:00:00
abstract::Sixteen acceptably randomized studies of anticoagulant therapy after cerebral or retinal ischemia or infarction are reviewed and the results among 1,046 anticoagulated patients and 1,071 controls are analyzed. The following conclusions are derived. 1) Anticoagulant therapy has not been shown to be better than control ...
journal_title:Stroke
pub_type: 临床试验,杂志文章,评审
doi:10.1161/01.str.19.8.1043
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Mild stroke (MS) and rapidly improving stroke (RIS) symptoms are common stroke presentations. Our objective is to describe the short-term outcomes in this population. METHODS:A retrospective analysis of patients with ischemic stroke in the Get With The Guidelines-Stroke registry who arrived ≤4.5...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.115.011528
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We studied prognosis for survival after an initial stroke in 662 patients who survived at least 30 days after onset while taking into account age, sex, the number of neurological deficits from the initial stroke, stroke type, and five selected medical conditions: hypertension, myocardial infarcti...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.26.11.2011
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To test the role of fibrinolysis in stroke, we used a mouse model in which preformed 2.5- to 3-microm-diameter fibrin microemboli are injected into the cerebral circulation. The microemboli lodge in the downstream precapillary vasculature and are susceptible to fibrinolysis. METHODS:We injected ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000137412.35700.0e
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:A comparison between long-term sensory sequelae of lateral medullary infarction (LMI) and medial medullary infarction (MMI) has never been made. METHODS:We studied 55 patients with medullary infarction (41 with LMI and 14 with MMI) who were followed up for >6 months. We examined and interviewed ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.30.12.2697
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We obtained magnetization transfer imaging (MTI) scans from individuals with cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) (1) to investigate the presence, extent, and nature of pathology in white and gray matter outside proton density (PD)-v...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.32.3.643
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There is little reported of the safety and efficacy of high-dose intravenous recombinant tissue plasminogen activator (alteplase) in combination with heparin anticoagulation in patients presenting with acute ischemic stroke. METHODS:Thirty-two patients with severe hemispheric stroke syndrome cau...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.23.5.646
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Neurological deterioration (ND) is a devastating complication after intracerebral hemorrhage but little is known about time course and predictors. METHODS:We performed a retrospective cohort study of placebo patients in intracerebral hemorrhage trials. We performed computed tomographic scans wit...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.114.007704
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To identify if the stroke-prone spontaneously hypertensive rat (SHRSP) exhibits impaired functional recovery after stroke compared with its normotensive reference strain, the Wistar Kyoto rat (WKY). METHODS:In study 1, a 2-mm distal middle cerebral artery occlusion (middle cerebral artery occlus...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000149629.32525.b7
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Aspirin is preventive against stroke not only because of its antithrombotic properties but also by other direct effects. The aim of this study was to elucidate its direct neuroprotective effects. METHODS:Viability parameters, glutamate release and uptake, and ATP levels were measured in cultured...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/hs0102.101299
更新日期:2002-01-01 00:00:00
abstract::Background and Purpose- Imaging is frequently used to select acute stroke patients for intra-arterial therapy. Quantitative cerebral blood flow can be measured noninvasively with arterial spin labeling magnetic resonance imaging. Cerebral blood flow levels in the contralateral (unaffected) hemisphere may affect capaci...
journal_title:Stroke
pub_type: 杂志文章,多中心研究
doi:10.1161/STROKEAHA.119.026499
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Familial aggregation of intracranial aneurysms (IAs) indicates a genetic role in the pathogenesis of this disease. Despite a number of reported susceptibility loci, no disease-causing gene variants have been identified. In this study, we used a parametric genomewide linkage approach to search for...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.534396
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Previous work has shown that cerebral microembolism detected with transcranial Doppler sonography distal to internal carotid artery stenosis occurs more frequently in recently symptomatic compared with asymptomatic patients. It has remained unclear whether cerebral microembolism also indicates a ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.26.11.2184
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Physiologically, it appears plausible for physical activity to decrease stroke risk; however, epidemiological studies have produced mixed findings. Furthermore, few studies have examined specific kinds and intensities of activities. The purpose of this study was to examine the association between...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.29.10.2049
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Evidence suggests that an alteration in cerebral hemodynamics plays a relevant role in the occurrence of stroke in patients with carotid occlusion. The purpose of the present study was to evaluate the relationships among baseline characteristics, type and number of collateral pathways, cerebral v...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.32.7.1552
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We sought to determine the effects of aging on regional cerebral blood flow and ischemic brain damage in transient cerebral ischemia in rats. METHODS:Five adult (5-6 months) and five aged (18-22 months) female spontaneously hypertensive rats were subjected to 20 minutes of bilateral carotid occl...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.22.11.1414
更新日期:1991-11-01 00:00:00
abstract::Neurologic deficits that occur simultaneously with or subsequent to internal carotid artery occlusion may be influenced by the adequacy of the intracerebral collateral circulation. Transcranial Doppler ultrasonography was used to evaluate mean middle cerebral artery blood velocity and blood flow in major collateral ar...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.19.5.589
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Accumulating evidence indicates that a variety of infections contribute to the pathogenesis of atherosclerosis, but there is controversy concerning the impact of Helicobacter pylori infections in atherosclerosis. METHODS:We evaluated seropositivity to H pylori and to its cytotoxin-associated gen...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000058481.82639.EF
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Fever after aneurysmal subarachnoid hemorrhage is associated with poor outcome. Because hydrocephalus and extravasated blood may influence thermoregulation, we determined whether these factors increase the risk for fever after subarachnoid hemorrhage. METHODS:Fever within 14 days (subdivided int...
journal_title:Stroke
pub_type: 信件
doi:10.1161/STROKEAHA.107.509851
更新日期:2008-07-01 00:00:00
abstract::In children with Moyamoya disease, transient ischemic attacks often occur during hyperventilation, and the frequency of attacks usually decreases with advancing age. To elucidate the mechanism of the attacks, the regional cerebral blood flow was measured during rest and/or hyperventilation in children aged 3-16 with M...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.18.5.906
更新日期:1987-09-01 00:00:00
abstract::Fundus fluorescein angiography was performed in 10 cases of occlusive carotid artery disease at presentation and after surgery or medical treatment. An improvement in the microcirculation of the retina was observed in 4 cases after carotid endarterectomy and in 1 case after carotid endarterectomy and extracranial-intr...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.18.3.585
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Noncontrast computed tomographic (CT) hypodensities have been shown to be associated with hematoma expansion in intracerebral hemorrhage (ICH), but their impact on functional outcome is yet to be determined. We evaluated whether baseline noncontrast CT hypodensities are associated with poor clini...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.116.014425
更新日期:2016-10-01 00:00:00