Expedited computed tomography perfusion and angiography in acute ischemic stroke: a feasibility study.
J Emerg Med
; 43(2): 308-15, 2012 Aug.
Article
in En
| MEDLINE
| ID: mdl-21497476
ABSTRACT
BACKGROUND:
Acute ischemic stroke diagnosis and treatment are among the most challenging in Emergency Medicine. Perfusion computed tomography (CTP) can increase the sensitivity for detecting ischemic stroke and, especially with the addition of CT angiography (CTA), improve decision-making regarding thrombolytic therapy compared to non-contrast computed tomography (NCCT) alone. However, because acute stroke protocols do not generally include procedures for multimodal imaging, they are not commonly performed. In addition, there is concern that additional studies could delay or preclude therapy in patients otherwise eligible for thrombolytic therapy.OBJECTIVES:
To demonstrate the feasibility of perfusion CTP and CTA in addition to NCCT of the brain in the emergency assessment of patients with acute ischemic stroke.METHODS:
Starting January 2008, multimodal (CTP and CTA) imaging was added to NCCT in the Emergency Department (ED) initial assessment of patients with stroke of ≤ 5 h duration. Over the subsequent 9 months, we measured the time from ED arrival to imaging and to recombinant tissue plasminogen activator (rt-PA) treatment and compared these times to patients evaluated with CT alone.RESULTS:
From January to October 2008, 95 patients had CTP and CTA studies in addition to NCCT for acute ischemic stroke. There were no differences between the average time to CT study or to rt-PA treatment between patients evaluated with multimodal CT imaging and patients assessed with NCCT alone.CONCLUSIONS:
Combining CTP and CTA with NCCT is feasible and does not adversely increase the time to CT imaging or rt-PA treatment in patients with acute ischemic stroke.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Perfusion
/
Tomography, X-Ray Computed
/
Brain Ischemia
/
Stroke
Type of study:
Guideline
/
Prognostic_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Emerg Med
Journal subject:
MEDICINA DE EMERGENCIA
Year:
2012
Document type:
Article
Affiliation country:
United States