Journal article
CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients
Clinical neurology and neurosurgery, Vol.115(12), pp.2471-2475
12/2013
DOI: 10.1016/j.clineuro.2013.09.036
PMID: 24176650
Abstract
Perfusion studies are increasingly used to triage acute stroke patients for endovascular recanalization therapies. We compare the safety and efficacy of CT perfusion (CTP)-guided to time-guided mechanical recanalization in acute ischemic stroke (AIS) patients.
A review was conducted on 132 patients, 94 undergoing CTP-guided and 38 undergoing time-guided (maximum 8h from symptom onset) mechanical recanalization at our institution.
The rate of partial-to-complete recanalization did not differ between the CTP and the non-CTP group (78.7% vs. 81.6%, respectively, p=0.71). ICH occurred respectively in 18.1% in the CTP group versus 31.6% in the non-CTP group (p=0.06). The overall in-hospital mortality rate was significantly lower in the CTP group (15.9% vs. 36.8%, p=0.04). In multivariable analysis, CTP-guided patient selection was an independent negative predictor of in-hospital mortality (OR=3.2; p=0.01). CTP-guided patient selection, however, was not a predictor of favorable outcome (Modified Rankin Scale 0–2 or 0–3).
CTP-based patient selection was associated with lower ICH and mortality rates. Favorable outcomes, however, did not differ between the 2 groups. These results may suggest a possible benefit in terms of in-hospital mortality with CTP-guided triage of AIS patients for endovascular treatment.
Details
- Title: Subtitle
- CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients
- Creators
- Nohra Chalouhi - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAGeorge Ghobrial - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAStavropoula Tjoumakaris - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAAaron S Dumont - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAL. Fernando Gonzalez - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USASamantha Witte - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAJustin Davanzo - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USARobert M Starke - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USACiro Randazzo - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAAdam E Flanders - Department of Neuroradiology, Thomas Jefferson University Hospital, Philadelphia, USADavid Hasan - Department of Neurosurgery, University of Iowa, Iowa City, USARohan Chitale - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USARobert Rosenwasser - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USAPascal Jabbour - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, USA
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.115(12), pp.2471-2475
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.clineuro.2013.09.036
- PMID
- 24176650
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Language
- English
- Date published
- 12/2013
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040291802771
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