Abstract 113: CT Perfusion Mismatch Identifies More Thrombectomy Patients Than Clinical Core Mismatch
| Autor: | Nawaf Yassi, Stephen N. Davis, Bernard Yan, Steven Bush, Lauren Pesavento, Gagan Sharma, Richard Dowling, Bruce C.V. Campbell, Peter J. Hand, Peter Mitchell, Edrich Rodrigues |
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| Rok vydání: | 2018 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty Core (anatomy) business.industry Large vessel Perfusion scanning medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Ischemic stroke medicine Neurology (clinical) Radiology Cardiology and Cardiovascular Medicine business Perfusion Stroke 030217 neurology & neurosurgery |
| Zdroj: | Stroke. 49 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background: Following DAWN and DEFUSE 3, optimal imaging selection of large vessel ischemic stroke patients for thrombectomy >6h is important. We hypothesized that perfusion mismatch used in EXTEND-IA and DEFUSE 3 would identify more patients eligible for thrombectomy than clinical-core mismatch used in DAWN. Methods: Prospectively collected data were analyzed for acute ischemic stroke patients aged>18 with pre-treatment whole brain CT perfusion from 2012-2017 at a comprehensive stroke center. CTP was omitted >6h in patients with extensive CT hypodensity. We compared the proportion of patients with anterior circulation large vessel occlusion (ICA, M1 and tandem occlusions) who fulfilled criteria for DAWN (clinical-core mismatch: age80 & NIHSS>10 with1.8, mismatch>15mL, core5) and EXTEND-IA (mismatch ratio>1.2, mismatch>10mL, core Results: Of 982 ischemic stroke patients evaluated with pre-treatment CTP, 291 had large vessel occlusion. Within 6h of stroke onset, 175/231 (76%) patients met EXTEND-IA criteria compared to 153/231 (60%) DEFUSE3 and 96/231 (42%) DAWN, p Conclusions: Perfusion mismatch selection would lead to substantially more patients receiving thrombectomy than clinical-core mismatch. These patients were generally older with milder NIHSS, but had similar probability of independent outcomes. |
| Databáze: | OpenAIRE |
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