Document Detail


A comparison of Computed Tomography perfusion-guided and time-guided endovascular treatments for patients with acute ischemic stroke.
MedLine Citation:
PMID:  20616318     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The role of CT perfusion (CT-P) imaging for the selection of patients with acute ischemic stroke who may benefit from endovascular treatment is not defined. The objective of this study was to determine whether CT-P-guided endovascular treatment improves clinical outcomes compared with standard endovascular treatment based on the time interval between symptom onset and presentation and noncontrast cranial CT imaging. METHODS: A retrospective study was performed comparing the clinical characteristics, complications, and clinical outcomes of patients with acute ischemic stroke who were treated using endovascular modalities based on either CT-P imaging (CT-P-guided) or time interval between symptom onset and presentation and absence of intracerebral hemorrhage or extensive ischemic changes on noncontrast cranial CT scan (time-guided). RESULTS: The rates of partial and complete recanalization were similar between the CT-P- and time-guided treatment groups (n=61 [88%] versus n=103 [81%]; P=0.52) regardless of whether they received intravenous recombinant tissue plasminogen activator before endovascular treatment. Comparing the CT-P-guided with the time-guided patients, favorable discharge outcome (modified Rankin Scale 0 to 2) was observed in 23 (32%) versus 41 (33%) of the patients, respectively (P=0.9). In-hospital mortality was observed in 15 (21%) of CT-P- and 29 (23%) of time-guided patients (P=0.74). CONCLUSIONS: CT-P-guided endovascular treatment did not increase the rate of short-term favorable outcomes among patients with acute ischemic stroke. Prospective studies are required to validate the CT-P criteria and protocols currently in use before incorporating CT-P as a routine modality for patient selection for endovascular treatment.
Authors:
Ameer E Hassan; Haralabos Zacharatos; Gustavo J Rodriguez; Gabriela Vazquez; Jefferson T Miley; Ramachandra P Tummala; M Fareed K Suri; Robert A Taylor; Adnan I Qureshi
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-07-08
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1673-8     Citation Subset:  IM    
Affiliation:
Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, Minneapolis, Minn 55455, USA. ameerehassan@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Brain Ischemia / drug therapy*,  radiography*
Female
Fibrinolytic Agents / therapeutic use
Humans
Male
Middle Aged
Patient Selection
Retrospective Studies
Stroke / drug therapy*,  radiography*
Thrombolytic Therapy / methods
Time Factors
Tissue Plasminogen Activator / therapeutic use*
Tomography, X-Ray Computed*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R0-1-NS44976-1A2/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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