Feina Shi1, Zhicai Chen1, Xiaoxian Gong1, Meixia Zhang1, David S Liebeskind2, Min Lou3,4. 1. Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China. 2. UCLA Stroke Center, University of California, Los Angeles, Los Angeles, CA, USA. 3. Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China. lm99@zju.edu.cn. 4. Zhejiang University Brain Research Institute, Zhejiang, Hangzhou, China. lm99@zju.edu.cn.
Abstract
OBJECTIVE: To investigate the value of multi-segment clot (MSC) sign on dynamic CT angiography (CTA) in predicting recanalisation and outcome after reperfusion therapy in acute ischaemic stroke (AIS) with large artery occlusion (LAO). METHODS: We retrospectively reviewed data of anterior circulation LAO patients from a prospectively collected database for consecutive AIS patients who underwent perfusion CT (CTP) before treatment. MSC sign was defined as the presence of multiple segments on dynamic CTA derived from CTP data. Good outcome was defined as modified Rankin score 0-3 at 90 days. RESULTS: A total of 181 LAO patients were enrolled. MSC sign was present in 73 (40.3%) patients. When compared with patients without MSC sign, patients with MSC sign had a significantly higher rate of recanalisation (76.7% versus 56.5%, p = 0.005) and good outcome (67.1% versus 51.0%, p = 0.035). Multivariable logistic regression analyses showed that MSC sign was an independent predictor for both recanalisation (OR [95% CI] = 2.237 [1.069-4.681]; p = 0.033) and good outcome (OR [95% CI] = 2.715 [1.154-6.388]; p = 0.022) after adjustment. CONCLUSIONS: The MSC sign is a good indicator for recanalisation and good outcome after reperfusion therapy in anterior circulation LAO patients. KEY POINTS: • MSC sign was present in about 40% acute anterior circulation LAO patients. • MSC sign is a predictor for recanalisation after reperfusion treatment. • Patients with MSC sign have a better outcome.
OBJECTIVE: To investigate the value of multi-segment clot (MSC) sign on dynamic CT angiography (CTA) in predicting recanalisation and outcome after reperfusion therapy in acute ischaemic stroke (AIS) with large artery occlusion (LAO). METHODS: We retrospectively reviewed data of anterior circulation LAO patients from a prospectively collected database for consecutive AISpatients who underwent perfusion CT (CTP) before treatment. MSC sign was defined as the presence of multiple segments on dynamic CTA derived from CTP data. Good outcome was defined as modified Rankin score 0-3 at 90 days. RESULTS: A total of 181 LAO patients were enrolled. MSC sign was present in 73 (40.3%) patients. When compared with patients without MSC sign, patients with MSC sign had a significantly higher rate of recanalisation (76.7% versus 56.5%, p = 0.005) and good outcome (67.1% versus 51.0%, p = 0.035). Multivariable logistic regression analyses showed that MSC sign was an independent predictor for both recanalisation (OR [95% CI] = 2.237 [1.069-4.681]; p = 0.033) and good outcome (OR [95% CI] = 2.715 [1.154-6.388]; p = 0.022) after adjustment. CONCLUSIONS: The MSC sign is a good indicator for recanalisation and good outcome after reperfusion therapy in anterior circulation LAO patients. KEY POINTS: • MSC sign was present in about 40% acute anterior circulation LAO patients. • MSC sign is a predictor for recanalisation after reperfusion treatment. • Patients with MSC sign have a better outcome.
Authors: Wolfgang G Kunz; Wieland H Sommer; Lukas Havla; Franziska Dorn; Felix G Meinel; Olaf Dietrich; Grete Buchholz; Birgit Ertl-Wagner; Kolja M Thierfelder Journal: Eur Radiol Date: 2016-10-08 Impact factor: 5.315
Authors: Hans T H Tu; Bruce C V Campbell; Soren Christensen; Patricia M Desmond; Deidre A De Silva; Mark W Parsons; Leonid Churilov; Maarten G Lansberg; Michael Mlynash; Jean-Marc Olivot; Matus Straka; Roland Bammer; Gregory W Albers; Geoffrey A Donnan; Stephen M Davis Journal: Int J Stroke Date: 2013-03-12 Impact factor: 5.266
Authors: W Hacke; M Kaste; C Fieschi; R von Kummer; A Davalos; D Meier; V Larrue; E Bluhmki; S Davis; G Donnan; D Schneider; E Diez-Tejedor; P Trouillas Journal: Lancet Date: 1998-10-17 Impact factor: 79.321
Authors: Maxim Mokin; Simon Morr; Sabareesh K Natarajan; Ning Lin; Kenneth V Snyder; L Nelson Hopkins; Adnan H Siddiqui; Elad I Levy Journal: J Neurointerv Surg Date: 2014-02-07 Impact factor: 5.836