Abstract
Objectives
Cerebral perfusion imaging may be used to identify the ischemic core in acute ischemic
stroke (AIS) patients with a large vessel occlusion of the anterior circulation; however,
perfusion parameters that predict the ischemic core in AIS patients with a basilar
artery occlusion (BAO) are poorly described. We determined which cerebral perfusion
parameters best predict the ischemic core after successful endovascular thrombectomy
(EVT) in BAO patients.
Materials and methods
We performed multicenter retrospective study of BAO patients with perfusion imaging
before EVT and a DWI after successful EVT. The ischemic core was defined as regions
on CTP, which were co-registered to the final DWI infarct. Various time-to-maximum
(Tmax) and cerebral blood flow (CBF) thresholds were compared to final infarct volume
to determine the best predictor of the final infarct.
Results
28 patients were included in the analysis for this study. Tmax >8s (r2: 0.56; median absolute error, 16.0 mL) and Tmax >10s (r2: 0.73; median absolute error, 11.3 mL) showed the strongest agreement between the
pre-EVT CTP study and the final DWI. CBF <38% (r2: 0.76; median absolute error, 8.2 mL) and CBF <34% (r2: 0.76; median absolute error, 9.1 mL) also correlated well with final infarct volume
on DWI.
Conclusions
Pre-EVT CT perfusion imaging is useful to predict the final ischemic infarct volume
in BAO patients. Tmax >8s and Tmax >10s were the strongest predictors of the post-EVT
final infarct volume.
Key Words
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Article info
Publication history
Published online: November 23, 2022
Accepted:
October 25,
2022
Received in revised form:
October 19,
2022
Received:
September 2,
2022
Footnotes
Sources of Funding: National Institutes of Health (NINDS) R01 NS121720-01.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106866
Copyright
© 2022 Elsevier Inc. All rights reserved.
