Single-Centre Experience with Patients Selection for Mechanical Thrombectomy Based on Automated Computed Tomography Perfusion Analysis-A Comparison with Computed TomographyCT Perfusion Thrombectomy Trials

VANÍČEK, Jiří, Petra CIMFLOVÁ, Martin BULIK, Jiří JARKOVSKÝ, Veronika PRELECOVÁ, Viktor SZEDER and Ondřej VOLNÝ. Single-Centre Experience with Patients Selection for Mechanical Thrombectomy Based on Automated Computed Tomography Perfusion Analysis-A Comparison with Computed TomographyCT Perfusion Thrombectomy Trials. JOURNAL OF STROKE & CEREBROVASCULAR DISEASES. AMSTERDAM: ELSEVIER SCIENCE BV, 2019, vol. 28, No 4, p. 1085-1092. ISSN 1052-3057. Available from: https://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.041.

Basic information

• Original name: Single-Centre Experience with Patients Selection for Mechanical Thrombectomy Based on Automated Computed Tomography Perfusion Analysis-A Comparison with Computed TomographyCT Perfusion Thrombectomy Trials
• Authors: VANÍČEK, Jiří (203 Czech Republic, belonging to the institution), Petra CIMFLOVÁ (203 Czech Republic, guarantor, belonging to the institution), Martin BULIK (203 Czech Republic, belonging to the institution), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), Veronika PRELECOVÁ (703 Slovakia, belonging to the institution), Viktor SZEDER (840 United States of America) and Ondřej VOLNÝ (203 Czech Republic, belonging to the institution).
• Edition: JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, AMSTERDAM, ELSEVIER SCIENCE BV, 2019, 1052-3057.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30103 Neurosciences
• Country of publisher: Netherlands
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 1.787
• RIV identification code: RIV/00216224:14110/19:00109662
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.041
• UT WoS: 000462349000042
• Keywords in English: Mechanical thrombectomy; CT perfusion; RAPID; single-centre experience
• Tags: 14110119, 14110127, 14119612, rivok
• Tags: International impact, Reviewed

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 orM2) 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 (IQR = 13-20), Alberta Stroke Program Early CT Score (ASPECTS) was 8 (IQR = 7-9), CTP core volume was 20 mL (IQR = 2-36), and CTP penumbra volume was 145.5 mL (IQR = 107-184). Time from stroke onset to imaging was 1 hour 32 minutes, time from stroke onset to reperfusion was 3 hours 50minutes, 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.