BACKGROUND AND PURPOSE: The role of CT perfusion (CT-P) imaging for the selection of patients with acute ischemic stroke who may benefit from endovascular treatment is not defined. The objective of this study was to determine whether CT-P-guided endovascular treatment improves clinical outcomes compared with standard endovascular treatment based on the time interval between symptom onset and presentation and noncontrast cranial CT imaging. METHODS: A retrospective study was performed comparing the clinical characteristics, complications, and clinical outcomes of patients with acute ischemic stroke who were treated using endovascular modalities based on either CT-P imaging (CT-P-guided) or time interval between symptom onset and presentation and absence of intracerebral hemorrhage or extensive ischemic changes on noncontrast cranial CT scan (time-guided). RESULTS: The rates of partial and complete recanalization were similar between the CT-P- and time-guided treatment groups (n=61 [88%] versus n=103 [81%]; P=0.52) regardless of whether they received intravenous recombinant tissue plasminogen activator before endovascular treatment. Comparing the CT-P-guided with the time-guided patients, favorable discharge outcome (modified Rankin Scale 0 to 2) was observed in 23 (32%) versus 41 (33%) of the patients, respectively (P=0.9). In-hospital mortality was observed in 15 (21%) of CT-P- and 29 (23%) of time-guided patients (P=0.74). CONCLUSIONS: CT-P-guided endovascular treatment did not increase the rate of short-term favorable outcomes among patients with acute ischemic stroke. Prospective studies are required to validate the CT-P criteria and protocols currently in use before incorporating CT-P as a routine modality for patient selection for endovascular treatment.
BACKGROUND AND PURPOSE: The role of CT perfusion (CT-P) imaging for the selection of patients with acute ischemic stroke who may benefit from endovascular treatment is not defined. The objective of this study was to determine whether CT-P-guided endovascular treatment improves clinical outcomes compared with standard endovascular treatment based on the time interval between symptom onset and presentation and noncontrast cranial CT imaging. METHODS: A retrospective study was performed comparing the clinical characteristics, complications, and clinical outcomes of patients with acute ischemic stroke who were treated using endovascular modalities based on either CT-P imaging (CT-P-guided) or time interval between symptom onset and presentation and absence of intracerebral hemorrhage or extensive ischemic changes on noncontrast cranial CT scan (time-guided). RESULTS: The rates of partial and complete recanalization were similar between the CT-P- and time-guided treatment groups (n=61 [88%] versus n=103 [81%]; P=0.52) regardless of whether they received intravenous recombinant tissue plasminogen activator before endovascular treatment. Comparing the CT-P-guided with the time-guided patients, favorable discharge outcome (modified Rankin Scale 0 to 2) was observed in 23 (32%) versus 41 (33%) of the patients, respectively (P=0.9). In-hospital mortality was observed in 15 (21%) of CT-P- and 29 (23%) of time-guided patients (P=0.74). CONCLUSIONS:CT-P-guided endovascular treatment did not increase the rate of short-term favorable outcomes among patients with acute ischemic stroke. Prospective studies are required to validate the CT-P criteria and protocols currently in use before incorporating CT-P as a routine modality for patient selection for endovascular treatment.
Authors: K Barlinn; J Seibt; K Engellandt; J Gerber; V Puetz; J Kepplinger; O Wunderlich; L-P Pallesen; U Bodechtel; R Koch; R von Kummer; I Dzialowski Journal: Clin Neuroradiol Date: 2014-08-23 Impact factor: 3.649
Authors: Clinton D Morgan; Marcus Stephens; Scott L Zuckerman; Magarya S Waitara; Peter J Morone; Michael C Dewan; J Mocco Journal: Interv Neuroradiol Date: 2015-06-10 Impact factor: 1.610
Authors: Ameer E Hassan; Haralabos Zacharatos; Saqib A Chaudhry; M Fareed K Suri; Gustavo J Rodriguez; Jefferson T Miley; Alberto Maud; Robert A Taylor; Mustapha A Ezzeddine; David C Anderson; Adnan I Qureshi Journal: Neurocrit Care Date: 2012-02 Impact factor: 3.210
Authors: Tasneem F Hasan; Nathaniel Todnem; Neethu Gopal; David A Miller; Sukhwinder S Sandhu; Josephine F Huang; Rabih G Tawk Journal: Curr Cardiol Rep Date: 2019-08-30 Impact factor: 2.931
Authors: A E Hassan; S A Chaudhry; J T Miley; R Khatri; S A Hassan; M F K Suri; A I Qureshi Journal: AJNR Am J Neuroradiol Date: 2012-07-19 Impact factor: 3.825
Authors: Kevin N Sheth; John B Terry; Raul G Nogueira; Anat Horev; Thanh N Nguyen; Albert K Fong; Dheeraj Gandhi; Shyam Prabhakaran; Dolora Wisco; Brenda A Glenn; Ashis H Tayal; Bryan Ludwig; Muhammad Shazam Hussain; Tudor G Jovin; Paul F Clemmons; Carolyn Cronin; David S Liebeskind; Melissa Tian; Rishi Gupta Journal: J Neurointerv Surg Date: 2012-10-16 Impact factor: 5.836