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논문 기본 정보

자료유형
학술저널
저자정보
Johanna M. Ospel (University of Calgary) Ondrej Volny (Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University) Wu Qiu (University of Calgary) Mohamed Najm (University of Calgary) Moiz Hafeez (University of Calgary) Sarah Abdalrahman (University of Calgary) Enrico Fainardi (University of Florence) Marta Rubiera (Hospital Vall d´Hebron) Alexander Khaw (London Health Sciences Centre University of Western Ontario) Jai J. Shankar (University of Manitoba) Michael D. Hill (University of Calgary) Mohammed A. Almekhlafi (University of Calgary) Andrew M. Demchuk (University of Calgary) Mayank Goyal (University of Calgary) Bijoy K. Menon (University of Calgary)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제23권 제3호
발행연도
2021.9
수록면
377 - 387 (11page)

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Background and Purpose Various imaging paradigms are used for endovascular treatment (EVT) decision-making and outcome estimation in acute ischemic stroke (AIS). We aim to compare how these imaging paradigms perform for EVT patient selection and outcome estimation. Methods Prospective multi-center cohort study of patients with AIS symptoms with multi-phase computed tomography angiography (mCTA) and computed tomography perfusion (CTP) baseline imaging. mCTA-based EVT-eligibility was defined as presence of large vessel occlusion (LVO) and moderate-to-good collaterals on mCTA. CTP-based eligibility was defined as presence of LVO, ischemic core (defined on relative cerebral blood flow, absolute cerebral blood flow, and cerebral blood volume maps) <70 mL, mismatch-ratio >1.8, absolute mismatch >15 mL. EVT-eligibility and adjusted rates of good outcome (modified Rankin Scale 0?2) based on these imaging paradigms were compared. Results Of 289/464 patients with LVO, 263 (91%) were EVT-eligible by mCTA-criteria versus 63 (22%), 19 (7%) and 103 (36%) by rCBF, aCBF, and CBV-CTP-criteria. CTP and mCTA-criteria were discordant in 40% to 53%. Estimated outcomes were best in patients who met both mCTA and CTP eligibility-criteria and were treated with EVT (62% to 87% good outcome). Patients eligible for EVT by mCTA-criteria and not by CTP-criteria receiving EVT achieved good outcome rates of 53% to 57%. Few patients met CTP-criteria and not mCTA-criteria for EVT. Conclusions Simpler imaging selection criteria that rely on little else than detection of the occluded blood vessel may be more sensitive and less specific, thus resulting in more patients being offered EVT and arguably benefiting from it.

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