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Value of Immediate Flat Panel Perfusion Imaging after Endovascular Therapy (AFTERMATH): A Proof of Concept Study.
Mujanovic, Adnan; Kurmann, Christoph C; Manhart, Michael; Piechowiak, Eike I; Pilgram-Pastor, Sara M; Serrallach, Bettina L; Boulouis, Gregoire; Meinel, Thomas R; Seiffge, David J; Jung, Simon; Arnold, Marcel; Nguyen, Thanh N; Fischer, Urs; Gralla, Jan; Dobrocky, Tomas; Mordasini, Pasquale; Kaesmacher, Johannes.
Afiliación
  • Mujanovic A; From the Departments of Diagnostic and Interventional Neuroradiology (A.M., C.C.K., E.I.P., S.M.P.-P., B.L.S., J.G., T.D., P.M., J.K.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Kurmann CC; Graduate School of Health Sciences (A.M., C.C.K.), University of Bern, Bern, Switzerland.
  • Manhart M; From the Departments of Diagnostic and Interventional Neuroradiology (A.M., C.C.K., E.I.P., S.M.P.-P., B.L.S., J.G., T.D., P.M., J.K.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Piechowiak EI; Department of Diagnostic, Interventional and Pediatric Radiology (C.C.K.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Pilgram-Pastor SM; Graduate School of Health Sciences (A.M., C.C.K.), University of Bern, Bern, Switzerland.
  • Serrallach BL; Siemens Healthineers, Advanced Therapies (M.M.), Forchheim, Germany.
  • Boulouis G; From the Departments of Diagnostic and Interventional Neuroradiology (A.M., C.C.K., E.I.P., S.M.P.-P., B.L.S., J.G., T.D., P.M., J.K.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Meinel TR; From the Departments of Diagnostic and Interventional Neuroradiology (A.M., C.C.K., E.I.P., S.M.P.-P., B.L.S., J.G., T.D., P.M., J.K.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Seiffge DJ; From the Departments of Diagnostic and Interventional Neuroradiology (A.M., C.C.K., E.I.P., S.M.P.-P., B.L.S., J.G., T.D., P.M., J.K.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Jung S; Departments of Diagnostic and Interventional Neuroradiology (G.B.), University Hospital Tours (Centre Val de Loire Region), Tours, France.
  • Arnold M; Department of Neurology (T.R.M., D.J.S., S.J., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Nguyen TN; Department of Neurology (T.R.M., D.J.S., S.J., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Fischer U; Department of Neurology (T.R.M., D.J.S., S.J., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Gralla J; Department of Neurology (T.R.M., D.J.S., S.J., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Dobrocky T; Department of Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
  • Mordasini P; Department of Neurology (T.R.M., D.J.S., S.J., M.A., U.F.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
  • Kaesmacher J; Department of Neurology (U.F.), University Hospital Basel, University of Basel, Basel, Switzerland.
AJNR Am J Neuroradiol ; 45(2): 163-170, 2024 02 07.
Article en En | MEDLINE | ID: mdl-38238089
ABSTRACT
BACKGROUND AND

PURPOSE:

Potential utility of flat panel CT perfusion imaging (FPCT-PI) performed immediately after mechanical thrombectomy (MT) is unknown. We aimed to assess whether FPCT-PI obtained directly post-MT could provide additional potentially relevant information on tissue reperfusion status. MATERIALS AND

METHODS:

This was a single-center analysis of all patients with consecutive acute stroke admitted between June 2019 and March 2021 who underwent MT and postinterventional FPCT-PI (n = 26). A core lab blinded to technical details and clinical data performed TICI grading on postinterventional DSA images and qualitatively assessed reperfusion on time-sensitive FPCT-PI maps. According to agreement between DSA and FPCT-PI, all patients were classified into 4 groups hypoperfusion findings perfectly matched by location (group 1), hypoperfusion findings mismatched by location (group 2), complete reperfusion on DSA with hypoperfusion on FPCT-PI (group 3), and hypoperfusion on DSA with complete reperfusion on FPCT-PI (group 4).

RESULTS:

Detection of hypoperfusion (present/absent) concurred in 21/26 patients. Of these, reperfusion findings showed perfect agreement on location and size in 16 patients (group 1), while in 5 patients there was a mismatch by location (group 2). Of the remaining 5 patients with disagreement regarding the presence or absence of hypoperfusion, 3 were classified into group 3 and 2 into group 4. FPCT-PI findings could have avoided TICI overestimation in all false-positive operator-rated TICI 3 cases (10/26).

CONCLUSIONS:

FPCT-PI may provide additional clinically relevant information in a considerable proportion of patients undergoing MT. Hence, FPCT-PI may complement the evaluation of reperfusion efficacy and potentially inform decision-making in the angiography suite.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Procedimientos Endovasculares Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: AJNR Am J Neuroradiol Año: 2024 Tipo del documento: Article País de afiliación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Procedimientos Endovasculares Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: AJNR Am J Neuroradiol Año: 2024 Tipo del documento: Article País de afiliación: Suiza