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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • 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

Published Date

  • December 2013

Published In

Volume / Issue

  • 115 / 12

Start / End Page

  • 2471 - 2475

PubMed ID

  • 24176650

Electronic International Standard Serial Number (EISSN)

  • 1872-6968

Digital Object Identifier (DOI)

  • 10.1016/j.clineuro.2013.09.036


  • eng

Conference Location

  • Netherlands