| A comparison of Computed Tomography perfusion-guided and time-guided endovascular treatments for patients with acute ischemic stroke. | |
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MedLine Citation:
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PMID: 20616318 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-07-08 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 41 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-27 Completed Date: 2010-08-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 1673-8 Citation Subset: IM |
Affiliation:
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Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, Minneapolis, Minn 55455, USA. ameerehassan@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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R0-1-NS44976-1A2/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator |
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