Perfusion recovery on TTP maps after endovascular stroke treatment might predict favorable neurological outcomes.

European Radiology
Jaewon ShinGyeong-Moon Kim

Abstract

Early recanalization and adequate collateral blood flow are surrogates for functional recovery in endovascular stroke treatment (EVT). We evaluated the prognostic value of pre- and immediate post-thrombectomy perfusion-weighted magnetic resonance imaging (PWI) parameters. Consecutive patients with acute ischemic stroke who underwent EVT were enrolled. Lesion volumes and their corresponding changes on diffusion-weighted (DWI) and PWI were assessed. Outcome was measured with modified Rankin Scale (mRS) at 90 days, and early neurological improvement (> 8 points improvement on National Institutes of Health Stroke Scale [NIHSS] or 0 to 1) at 7 days. Fifty-two patients were enrolled. After control of initial NIHSS and recanalization status, post-thrombectomy time-to-peak (TTP) hypoperfused volume and TTP hypoperfused volume change remained independent predictors of favorable functional outcome (odds ratio [OR] = 0.13, 95% confidence interval [CI] = 0.03-0.54, p = 0.005; OR = 1.018, 95% CI = 1.00-1.03, p = 0.017), and early neurological improvement (OR = 0.20, 95% CI 0.07-0.58, p = 0.003; OR = 1.02, 95% CI = 1.00-1.03, p = 0.010). The areas under the curve of post-thrombectomy TTP hypoperfused volume and TTP hypoperfused volume change...Continue Reading

References

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Sep 8, 2012·Lancet Neurology·Maarten G LansbergUNKNOWN DEFUSE 2 study investigators
Sep 22, 2012·Stroke; a Journal of Cerebral Circulation·Marc-Antoine LabeyrieCatherine Oppenheim
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Jul 3, 2015·TheScientificWorldJournal·Ozcan OzdemirErtugrul Colak
May 10, 2017·Annals of Neurology·Maarten G LansbergUNKNOWN CT Perfusion to Predict Response to Recanalization in Ischemic Stroke Project (CRISP) Investigators
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Jan 10, 2018·Annals of Neurology·Yu XieUNKNOWN THRACE investigators
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