Abstract
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: 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: 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: Our analysis of CTP-selected patients for MT supports clinical applicability of automated
CTP analysis into everyday clinical practice.
Key Words
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Article info
Publication history
Published online: January 14, 2019
Accepted:
December 26,
2018
Received in revised form:
December 20,
2018
Received:
October 3,
2018
Footnotes
Funding Statement: This work was supported by the National Program of Sustainability II, Czech Republic, grant number LQ1605.
Competing Interests Statement: Petra Cimflova is a consultant for iSchemaView, Inc.; no other relationships or activities that could appear to have influenced the submitted work.
Contributorship Statement: Drs. Vanicek, Cimflova, Bulik, Szeder and Volny—substantial contributions to the conception and design of the work, drafting the work, and revising it critically for intellectual content. Drs. Jarkovsky and Prelecova—analysis and interpretation of data. Erick Harr—English editing.
Informed consent was obtained from all individual participants included in the study.
Level of Evidence: Level 4, Case series.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.041
Copyright
© 2019 Published by Elsevier Inc. on behalf of National Stroke Association.
