Single-Centre Experience with Patients Selection for Mechanical Thrombectomy Based on Automated Computed Tomography Perfusion Analysis-A Comparison with Computed TomographyCT Perfusion Thrombectomy Trials.
J Stroke Cerebrovasc Dis
; 28(4): 1085-1092, 2019 Apr.
Article
em En
| MEDLINE
| ID: mdl-30655040
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 (IQRâ¯=â¯13-20), Alberta Stroke Program Early CT Score (ASPECTS) was 8 (IQRâ¯=â¯7-9), CTP core volume was 20 mL (IQRâ¯=â¯2-36), and CTP penumbra volume was 145.5 mL (IQRâ¯=â¯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.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
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Circulação Cerebrovascular
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Ensaios Clínicos como Assunto
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Trombectomia
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Seleção de Pacientes
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Acidente Vascular Cerebral
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Imagem de Perfusão
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Tomada de Decisão Clínica
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Angiografia por Tomografia Computadorizada
Tipo de estudo:
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Stroke Cerebrovasc Dis
Assunto da revista:
ANGIOLOGIA
/
CEREBRO
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
República Tcheca