Single-Centre Experience with Patients Selection for Mechanical Thrombectomy Based on Automated Computed Tomography Perfusion Analysis-A Comparison with Computed TomographyCT Perfusion Thrombectomy Trials.
Aged
Aged, 80 and over
Brain Ischemia
/ diagnostic imaging
Cerebrovascular Circulation
Clinical Decision-Making
Clinical Trials as Topic
/ methods
Computed Tomography Angiography
/ methods
Disability Evaluation
Female
Humans
Male
Middle Aged
Patient Selection
Perfusion Imaging
/ methods
Predictive Value of Tests
Retrospective Studies
Stroke
/ diagnostic imaging
Thrombectomy
/ methods
Treatment Outcome
CT perfusion
Mechanical thrombectomy
RAPID
single-centre experience
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
03
10
2018
revised:
20
12
2018
accepted:
26
12
2018
pubmed:
19
1
2019
medline:
10
4
2019
entrez:
19
1
2019
Statut:
ppublish
Résumé
In randomized clinical trials, mechanical thrombectomy (MT) was proved to be a highly effective treatment of acute ischemic stroke which improved clinical outcomes. Some of the trials used automated computed tomography perfusion (CTP) analysis for selection of participants. We present a single-center experience with CTP selection and comparison with CTP trials. Data of consecutive MT patients (from January 2016 to December 2017) were retrospectively reviewed. All patients with multiphase CT angiography confirmed the presence of anterior circulation large vessel occlusion/s in the intracranial internal carotid artery and/or middle cerebral artery (M1 or M2) and with admission brain CTP analyzed by RAPID software were included into the analysis. Sixty-two patients fulfilled the inclusion criteria (mean age was 70.1 ± 13.6 years, females 48.5%). At baseline, National Institutes of Health Stroke Scale score was 16 (IQR = 13-20), Alberta Stroke Program Early CT Score (ASPECTS) was 8 (IQR = 7-9), CTP core volume was 20 mL (IQR = 2-36), and CTP penumbra volume was 145.5 mL (IQR = 107-184). Time from stroke onset to imaging was 1 hour 32 minutes, time from stroke onset to reperfusion was 3 hours 50 minutes, and median time from CT to reperfusion was 1 hour 56 minutes. Modified thrombolysis in cerebral infarction 2b/3 was achieved in 42 patients (67.7%). Twenty-three patients (37%) had modified Rankin scale 0-2 at 90 days. Our analysis of CTP-selected patients for MT supports clinical applicability of automated CTP analysis into everyday clinical practice.
Sections du résumé
BACKGROUND
BACKGROUND
In randomized clinical trials, mechanical thrombectomy (MT) was proved to be a highly effective treatment of acute ischemic stroke which improved clinical outcomes. Some of the trials used automated computed tomography perfusion (CTP) analysis for selection of participants. We present a single-center experience with CTP selection and comparison with CTP trials.
METHODS
METHODS
Data of consecutive MT patients (from January 2016 to December 2017) were retrospectively reviewed. All patients with multiphase CT angiography confirmed the presence of anterior circulation large vessel occlusion/s in the intracranial internal carotid artery and/or middle cerebral artery (M1 or M2) and with admission brain CTP analyzed by RAPID software were included into the analysis.
RESULTS
RESULTS
Sixty-two patients fulfilled the inclusion criteria (mean age was 70.1 ± 13.6 years, females 48.5%). At baseline, National Institutes of Health Stroke Scale score was 16 (IQR = 13-20), Alberta Stroke Program Early CT Score (ASPECTS) was 8 (IQR = 7-9), CTP core volume was 20 mL (IQR = 2-36), and CTP penumbra volume was 145.5 mL (IQR = 107-184). Time from stroke onset to imaging was 1 hour 32 minutes, time from stroke onset to reperfusion was 3 hours 50 minutes, and median time from CT to reperfusion was 1 hour 56 minutes. Modified thrombolysis in cerebral infarction 2b/3 was achieved in 42 patients (67.7%). Twenty-three patients (37%) had modified Rankin scale 0-2 at 90 days.
CONCLUSIONS
CONCLUSIONS
Our analysis of CTP-selected patients for MT supports clinical applicability of automated CTP analysis into everyday clinical practice.
Identifiants
pubmed: 30655040
pii: S1052-3057(18)30743-2
doi: 10.1016/j.jstrokecerebrovasdis.2018.12.041
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1085-1092Informations de copyright
Copyright © 2019. Published by Elsevier Inc.