Background: CT perfusion (CTP) is used in patients with anterior circulation acute ischemic stroke (AIS) for predicting the final infarct volume (FIV). Tandem occlusion (TO), involving both intracranial large vessels and the ipsilateral cervical internal carotid artery could generate hemodynamic changes altering perfusion parameters. Our aim is to evaluate the accuracy of CTP in the prediction of the FIV in TOs. Methods: consecutive patients with AIS due to middle cerebral artery occlusion, referred to a tertiary stroke center between March 2019 and January 2021, with an automated CTP and successful recanalization (mTICI = 2b - 3) after endovascular treatment were retrospectively included in the tandem group (TG) or in the control group (CG). Patients with parenchymal hematoma type 2, according to ECASS II classification of hemorrhagic transformations, were excluded in a secondary analysis. Demographic, clinical, radiological, time intervals, safety, and outcome measures were collected. Results: among 319 patients analyzed, a comparison between the TG (N = 22) and CG (n = 37) revealed similar cerebral blood flow (CBF) > 30% (29.50 +/- 32.33 vs. 15.76 +/- 20.93 p = 0.18) and FIV (54.67 +/- 65.73 vs. 55.14 +/- 64.64 p = 0.875). Predicted ischemic core (PIC) and FIV correlated in both TG (tau = 0.761, p < 0.001) and CG (tau = 0.315, p = 0.029). The Bland-Altmann plot showed agreement between PIC and FIV for both groups, mainly in the secondary analysis. Conclusion: automated CTP could represent a good predictor of FIV in patients with AIS due to TO.

Lacidogna, G., Pitocchi, F., Mascolo, A.p., Marrama, F., D'Agostino, F., Rocco, A., et al. (2023). CT Perfusion as a Predictor of the Final Infarct Volume in Patients with Tandem Occlusion. JOURNAL OF PERSONALIZED MEDICINE, 13(2), 342 [10.3390/jpm13020342].

CT Perfusion as a Predictor of the Final Infarct Volume in Patients with Tandem Occlusion

Morosetti, Daniele;Garaci, Francesco;Di Giuliano, Francesca;Floris, Roberto;Diomedi, Marina;Da Ros, Valerio
2023-02-16

Abstract

Background: CT perfusion (CTP) is used in patients with anterior circulation acute ischemic stroke (AIS) for predicting the final infarct volume (FIV). Tandem occlusion (TO), involving both intracranial large vessels and the ipsilateral cervical internal carotid artery could generate hemodynamic changes altering perfusion parameters. Our aim is to evaluate the accuracy of CTP in the prediction of the FIV in TOs. Methods: consecutive patients with AIS due to middle cerebral artery occlusion, referred to a tertiary stroke center between March 2019 and January 2021, with an automated CTP and successful recanalization (mTICI = 2b - 3) after endovascular treatment were retrospectively included in the tandem group (TG) or in the control group (CG). Patients with parenchymal hematoma type 2, according to ECASS II classification of hemorrhagic transformations, were excluded in a secondary analysis. Demographic, clinical, radiological, time intervals, safety, and outcome measures were collected. Results: among 319 patients analyzed, a comparison between the TG (N = 22) and CG (n = 37) revealed similar cerebral blood flow (CBF) > 30% (29.50 +/- 32.33 vs. 15.76 +/- 20.93 p = 0.18) and FIV (54.67 +/- 65.73 vs. 55.14 +/- 64.64 p = 0.875). Predicted ischemic core (PIC) and FIV correlated in both TG (tau = 0.761, p < 0.001) and CG (tau = 0.315, p = 0.029). The Bland-Altmann plot showed agreement between PIC and FIV for both groups, mainly in the secondary analysis. Conclusion: automated CTP could represent a good predictor of FIV in patients with AIS due to TO.
16-feb-2023
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/26 - NEUROLOGIA
Settore MED/37 - NEURORADIOLOGIA
English
Con Impact Factor ISI
CT perfusion
mechanical thrombectomy
stroke
tandem occlusion
Lacidogna, G., Pitocchi, F., Mascolo, A.p., Marrama, F., D'Agostino, F., Rocco, A., et al. (2023). CT Perfusion as a Predictor of the Final Infarct Volume in Patients with Tandem Occlusion. JOURNAL OF PERSONALIZED MEDICINE, 13(2), 342 [10.3390/jpm13020342].
Lacidogna, G; Pitocchi, F; Mascolo, Ap; Marrama, F; D'Agostino, F; Rocco, A; Mori, F; Maestrini, I; Sabuzi, F; Cavallo, A; Morosetti, D; Garaci, F; Di...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/321262
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