Utility of Time-Variant Multiphase CTA Color Maps in Outcome Prediction for Acute Ischemic Stroke Due to Anterior Circulation Large Vessel Occlusion

OSPEL, Johanna M., Petra CIMFLOVÁ, Ondřej VOLNÝ, Wu QIU, Moiz HAFEEZ, Arnuv MAYANK, Mohamed NAJM, Kevin CHUNG, Nima KASHANI, Mohammed A. ALMEKHLAFI, Bijoy K. MENON and Mayank GOYAL. Utility of Time-Variant Multiphase CTA Color Maps in Outcome Prediction for Acute Ischemic Stroke Due to Anterior Circulation Large Vessel Occlusion. CLINICAL NEURORADIOLOGY. HEIDELBERG: SPRINGER HEIDELBERG, 2021, vol. 31, No 3, p. 783-790. ISSN 1869-1439. Available from: https://dx.doi.org/10.1007/s00062-020-00958-3.

Basic information

• Original name: Utility of Time-Variant Multiphase CTA Color Maps in Outcome Prediction for Acute Ischemic Stroke Due to Anterior Circulation Large Vessel Occlusion
• Authors: OSPEL, Johanna M. (756 Switzerland), Petra CIMFLOVÁ (203 Czech Republic, belonging to the institution), Ondřej VOLNÝ (203 Czech Republic, belonging to the institution), Wu QIU, Moiz HAFEEZ, Arnuv MAYANK, Mohamed NAJM, Kevin CHUNG, Nima KASHANI, Mohammed A. ALMEKHLAFI, Bijoy K. MENON and Mayank GOYAL (guarantor).
• Edition: CLINICAL NEURORADIOLOGY, HEIDELBERG, SPRINGER HEIDELBERG, 2021, 1869-1439.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30103 Neurosciences
• Country of publisher: Germany
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 3.156
• RIV identification code: RIV/00216224:14110/21:00120749
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1007/s00062-020-00958-3
• UT WoS: 000572716700001
• Keywords in English: Ischemic stroke; Collaterals; Large vessel occlusion
• Tags: 14110119, 14119612, 14119613, rivok
• Tags: International impact, Reviewed

Abstract

Background Multiphase CTA (mCTA) is an established tool for endovascular treatment decision-making and outcome prediction in acute ischemic stroke, but its interpretation requires some degree of experience. We aimed to determine whether mCTA-based prediction of clinical outcome and final infarct volume can be improved by assessing collateral status on time-variant mCTA color maps rather than using a conventional mCTA display format. Methods Patients from the PRove-IT cohort study with anterior circulation large vessel occlusion were included in this study. Collateral status was assessed with a three-point scale using the conventional display format. Collateral extent and filling dynamics were then graded on a three-point scale using time-variant mCTA color-maps (FastStroke, GE Healthcare, Milwaukee, WI, USA). Multivariable logistic regression was performed to determine the association of conventional collateral score, color-coded collateral extent and color-coded collateral filling dynamics with good clinical outcome and final infarct volume (volume below vs. above median infarct volume in the study sample). Results A total of 285 patients were included in the analysis and 53% (152/285) of the patients achieved a good outcome. Median infarct volume on follow-up was 12.6ml. Color-coded collateral extent was significantly associated with good outcome (adjusted odds ratio [adjOR] 0.53, 95% confidence interval [CI]:0.36-0.77) while color-coded collateral filling dynamics (adjOR 1.30 [95%CI:0.88-1.95]) and conventional collateral scoring (adjOR 0.72 [95%C:0.48-1.08]) were not. Both color-coded collateral extent (adjOR 2.67 [95%CI:1.80-4.00]) and conventional collateral scoring (adjOR 1.84 [95%CI:1.21-2.79]) were significantly associated with follow-up infarct volume, while color-coded collateral filling dynamics were not (adjOR 1.21 [95%CI:0.83-1.78]). Conclusion In this study, collateral extent assessment on time-variant mCTA maps improved prediction of good outcome and has similar value in predicting follow-up infarct volume compared to conventional mCTA collateral grading.