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CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients.

Publication ,  Journal Article
Chalouhi, N; Ghobrial, G; Tjoumakaris, S; Dumont, AS; Gonzalez, LF; Witte, S; Davanzo, J; Starke, RM; Randazzo, C; Flanders, AE; Hasan, D ...
Published in: Clin Neurol Neurosurg
December 2013

OBJECTIVE: Perfusion studies are increasingly used to triage acute stroke patients for endovascular recanalization therapies. We compare the safety and efficacy of CT perfusion (CTP)-guided to time-guided mechanical recanalization in acute ischemic stroke (AIS) patients. METHODS: A review was conducted on 132 patients, 94 undergoing CTP-guided and 38 undergoing time-guided (maximum 8h from symptom onset) mechanical recanalization at our institution. RESULTS: The rate of partial-to-complete recanalization did not differ between the CTP and the non-CTP group (78.7% vs. 81.6%, respectively, p=0.71). ICH occurred respectively in 18.1% in the CTP group versus 31.6% in the non-CTP group (p=0.06). The overall in-hospital mortality rate was significantly lower in the CTP group (15.9% vs. 36.8%, p=0.04). In multivariable analysis, CTP-guided patient selection was an independent negative predictor of in-hospital mortality (OR=3.2; p=0.01). CTP-guided patient selection, however, was not a predictor of favorable outcome (Modified Rankin Scale 0-2 or 0-3). CONCLUSIONS: CTP-based patient selection was associated with lower ICH and mortality rates. Favorable outcomes, however, did not differ between the 2 groups. These results may suggest a possible benefit in terms of in-hospital mortality with CTP-guided triage of AIS patients for endovascular treatment.

Duke Scholars

Published In

Clin Neurol Neurosurg

DOI

EISSN

1872-6968

Publication Date

December 2013

Volume

115

Issue

12

Start / End Page

2471 / 2475

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Tissue Plasminogen Activator
  • Thrombolytic Therapy
  • Thrombectomy
  • Stroke
  • Perfusion
  • Patient Selection
  • Neurology & Neurosurgery
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chalouhi, N., Ghobrial, G., Tjoumakaris, S., Dumont, A. S., Gonzalez, L. F., Witte, S., … Jabbour, P. (2013). CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients. Clin Neurol Neurosurg, 115(12), 2471–2475. https://doi.org/10.1016/j.clineuro.2013.09.036
Chalouhi, Nohra, George Ghobrial, Stavropoula Tjoumakaris, Aaron S. Dumont, L Fernando Gonzalez, Samantha Witte, Justin Davanzo, et al. “CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients.Clin Neurol Neurosurg 115, no. 12 (December 2013): 2471–75. https://doi.org/10.1016/j.clineuro.2013.09.036.
Chalouhi N, Ghobrial G, Tjoumakaris S, Dumont AS, Gonzalez LF, Witte S, et al. CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients. Clin Neurol Neurosurg. 2013 Dec;115(12):2471–5.
Chalouhi, Nohra, et al. “CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients.Clin Neurol Neurosurg, vol. 115, no. 12, Dec. 2013, pp. 2471–75. Pubmed, doi:10.1016/j.clineuro.2013.09.036.
Chalouhi N, Ghobrial G, Tjoumakaris S, Dumont AS, Gonzalez LF, Witte S, Davanzo J, Starke RM, Randazzo C, Flanders AE, Hasan D, Chitale R, Rosenwasser R, Jabbour P. CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients. Clin Neurol Neurosurg. 2013 Dec;115(12):2471–2475.
Journal cover image

Published In

Clin Neurol Neurosurg

DOI

EISSN

1872-6968

Publication Date

December 2013

Volume

115

Issue

12

Start / End Page

2471 / 2475

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Tissue Plasminogen Activator
  • Thrombolytic Therapy
  • Thrombectomy
  • Stroke
  • Perfusion
  • Patient Selection
  • Neurology & Neurosurgery
  • Middle Aged