Automated Perfusion Calculations vs. Visual Scoring of Collaterals and CBV-ASPECTS : Has the Machine Surpassed the Eye?
Marios-Nikos Psychogios,Peter B. Sporns,Peter B. Sporns,Johanna M. Ospel,Johanna M. Ospel,Aristeidis H. Katsanos,Aristeidis H. Katsanos,Reza Kabiri,Fabian Flottmann,Bijoy K Menon,MacKenzie Horn,David S Liebeskind,Tristan Honda,Marc Ribó,Manuel Requena Ruiz,Christoph Kabbasch,Thorsten Lichtenstein,Christoph Maurer,Ansgar Berlis,Victoria Hellstern,Hans Henkes,Markus A Möhlenbruch,Fatih Seker,Marielle Ernst,Jan Liman,Georgios Tsivgoulis,Georgios Tsivgoulis,Alex Brehm +27 more
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TLDR
Collateral scoring, CBV-ASPECTS and RAPID were independently associated with functional outcome at 90 days and core and penumbra estimates using automated software packages varied significantly and should therefore be used with caution.Abstract:
Use of automated perfusion software has gained importance for imaging of stroke patients for mechanical thrombectomy (MT). We aim to compare four perfusion software packages: 1) with respect to their association with 3‑month functional outcome after successful reperfusion with MT in comparison to visual Cerebral Blood Volume - Alberta Stroke Program Early CT Score (CBV-ASPECTS) and collateral scoring and 2) with respect to their agreement in estimation of core and penumbra volume. This retrospective, multicenter cohort study (2015–2019) analyzed data from 8 centers. We included patients who were functionally independent before and underwent successful MT of the middle cerebral artery. Primary outcome measurements were the relationship of core and penumbra volume calculated by each software, qualitative assessment of collaterals and CBV-APECTS with 3‑month functional outcome and disability (modified Rankin scale >2). Quantitative differences between perfusion software measurements were also assessed. A total of 215 patients (57% women, median age 77 years) from 8 centers fulfilled the inclusion criteria. Multivariable analyses showed a significant association of RAPID core (common odds ratio, cOR 1.02; p = 0.015), CBV-ASPECTS (cOR 0.78; p = 0.007) and collaterals (cOR 0.78; p = 0.001) with 3‑month functional outcome (shift analysis), while RAPID core (OR 1.02; p = 0.018), CBV-ASPECTS (OR 0.77; p = 0.024), collaterals (OR 0.78; p = 0.007) and OLEA core (OR 1.02; p = 0.029) were significantly associated with 3‑month functional disability. Mean differences on core estimates between VEOcore and RAPID were 13.4 ml, between syngo.via and RAPID 30.0 ml and between OLEA and RAPID −3.2 ml. Collateral scoring, CBV-ASPECTS and RAPID were independently associated with functional outcome at 90 days. Core and Penumbra estimates using automated software packages varied significantly and should therefore be used with caution.read more
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Novel selection paradigms for endovascular stroke treatment in the extended time window.
Mehdi Bouslama,Diogo C Haussen,Diogo C Haussen,Gabriel M Rodrigues,Gabriel M Rodrigues,Clara M Barreira,Clara M Barreira,Michael Frankel,Michael Frankel,Raul G Nogueira +9 more
TL;DR: ASPECTS-based selection paradigms for late presenting and wake-up strokes ET have comparable proportions of qualifying patients and similar 90-day functional outcomes as DAWN-CCM and DEFUSE-3-PIM and might lead to better outcome discrimination.
Journal ArticleDOI
Clinical Imaging of the Penumbra in Ischemic Stroke: From the Concept to the Era of Mechanical Thrombectomy
L. Chalet,Timothé Boutelier,Thomas Christen,Dorian Raguenes,Justine Debatisse,Omer Eker,Guillaume Becker,Norbert Nighoghossian,Tae-Hee Cho,Emmanuelle Canet-Soulas,Laura Mechtouff +10 more
TL;DR: An overview of the evolution of the ischemic penumbra imaging methods, including their respective strengths and limitations, is provided to map the current intellectual structure of the field using bibliometric analysis and explore future directions.
Journal ArticleDOI
Stroke imaging prior to thrombectomy in the late window: results from a pooled multicentre analysis
Mohammed A. Almekhlafi,John Thornton,Ilaria Casetta,Mayank Goyal,Stefania Nannoni,Darragh Herlihy,Enrico Fainardi,Sarah Power,Valentina Saia,Aidan Hegarty,Giovanni Pracucci,Andrew M. Demchuk,Salvatore Mangiafico,Karl Boyle,Patrik Michel,Fouzi Bala,Rubina Gill,Andrea M. Kuczynski,Ayolla Ademola,Michael D. Hill,Danilo Toni,Sean Murphy,Beom Joon Kim,Bijoy K Menon +23 more
TL;DR: This pooled analysis of late window EVT showed comparable functional outcomes in patients selected for EVT using collateral imaging alone compared with patients selected using perfusion and collateral imaging.
Journal ArticleDOI
What is the impact of head movement on automated CT perfusion mismatch evaluation in acute ischemic stroke
Arne Potreck,Fatih Seker,Matthias A. Mutke,Charlotte S. Weyland,Christian Herweh,Sabine Heiland,Martin Bendszus,Markus A Möhlenbruch +7 more
TL;DR: In this article, the authors evaluated the influence of head movement on automated CT perfusion mismatch evaluation in acute ischemic stroke patients and found that head movement alone had only a minor impact on mismatch evaluation.
Journal ArticleDOI
Quantitative collateral assessment evaluated by cerebral blood volume measured by CT perfusion in patients with acute ischemic stroke.
Sakyo Hirai,Yoji Tanaka,Hirotaka Sato,Koichi Kato,Yongson Kim,Toshihiro Yamamura,Kazutaka Sumita,Toshinari Arai +7 more
TL;DR: In this article, the authors proposed a quantitative assessment of CS using cerebral blood volume (CBV) measured by computed tomography perfusion (CTP) imaging, which is considered a predictor of clinical outcome after reperfusion therapy (RT) in patients with acute ischemic stroke.
References
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Journal ArticleDOI
Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
William J. Powers,Alejandro A. Rabinstein,Teri Ackerson,Opeolu Adeoye,Nicholas C. Bambakidis,Kyra J. Becker,José Biller,Michael D. Brown,Bart M. Demaerschalk,Brian L. Hoh,Edward C. Jauch,Chelsea S. Kidwell,Thabele M Leslie-Mazwi,Bruce Ovbiagele,Phillip A. Scott,Kevin N. Sheth,Andrew M. Southerland,Deborah V. Summers,David L. Tirschwell +18 more
TL;DR: These guidelines supersede the prior 2007 guidelines and 2009 updates and support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit.
Journal ArticleDOI
Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke
Mayank Goyal,Muneer Eesa,John Thornton,Denis-Claude Roy,Dar Dowlatshahi,Ashfaq Shuaib,D. Tampieri,David Williams,H. Choe,Brian T. Jankowitz,Michael Kelly,Guillermo Linares,Jai Jai Shiva Shankar,Alain Weill,Suresh Subramaniam,Abstr Act +15 more
TL;DR: In this paper, the authors evaluated rapid endovascular treatment in addition to standard care in patients with acute ischemic stroke with a small infarct core, a proximal intracranial arterial occlusion, and moderate-to-good collateral circulation.
Journal ArticleDOI
Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection
Bruce C.V. Campbell,Leonid Churilov,Nawaf Yassi,Bernard Yan,M. Brooks,F. Miteff,Martin Krause,M. Priglinger,Timothy Ang,Rebecca Scroop,Ben McGuinness,Tissa Wijeratne,Winston Chong,Monica S Badve,H. Rice,L. de Villiers,Henry Ma,Abstr Act +17 more
TL;DR: In patients with ischemic stroke with a proximal cerebral arterial occlusion and salvageable tissue on CT perfusion imaging, early thrombectomy with the Solitaire FR stent retriever, as compared with alteplase alone, improved reperfusion, early neurologic recovery, and functional outcome.
Journal ArticleDOI
Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.
William J. Powers,Alejandro A. Rabinstein,Teri Ackerson,Opeolu Adeoye,Nicholas C. Bambakidis,Kyra J. Becker,José Biller,Michael D. Brown,Bart M. Demaerschalk,Brian L. Hoh,Edward C. Jauch,Chelsea S. Kidwell,Thabele M Leslie-Mazwi,Bruce Ovbiagele,Phillip A. Scott,Kevin N. Sheth,Andrew M. Southerland,Deborah V. Summers,David L. Tirschwell +18 more
TL;DR: These guidelines detail prehospital care, urgent and emergency evaluation and treatment with intravenous and intra-arterial therapies, and in-hospital management, including secondary prevention measures that are appropriately instituted within the first 2 weeks.
Journal ArticleDOI
Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct.
Raul G Nogueira,Ashutosh P Jadhav,Diogo C Haussen,Alain Bonafe,Ronald F. Budzik,Parita Bhuva,Dileep R. Yavagal,Marc Ribo,Christophe Cognard,Ricardo A. Hanel,Cathy A. Sila,Ameer E Hassan,Mónica Millán,Elad I. Levy,Peter Mitchell,Michael Chen,Joey English,Qaisar A. Shah,Frank L. Silver,Vitor Mendes Pereira,Brijesh P Mehta,Blaise Baxter,Michael G. Abraham,Pedro Cardona,Erol Veznedaroglu,Frank R Hellinger,Lei Feng,Jawad F. Kirmani,Demetrius K. Lopes,Brian T. Jankowitz,Michael Frankel,Vincent Costalat,Nirav Vora,Albert J Yoo,Amer M. Malik,Anthony J. Furlan,Marta Rubiera,Amin Aghaebrahim,Jean-Marc Olivot,Wondwossen G Tekle,Ryan K. Shields,Todd Graves,Roger J. Lewis,Wade S. Smith,David S Liebeskind,Jeffrey L. Saver,Tudor G Jovin +46 more
TL;DR: Among patients with acute stroke who had last been known to be well 6 to 24 hours earlier and who had a mismatch between clinical deficit and infarct, outcomes for disability at 90 days were better with thrombectomy plus standard care than with standard care alone.