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Borst, Jordi;
Berkhemer, Olvert A.;
Roos, Yvo B.W.E.M.;
van Bavel, Ed;
van Zwam, Wim H.;
van Oostenbrugge, Robert J.;
van Walderveen, Marianne A.A.;
Lingsma, Hester F.;
van der Lugt, Aad;
Dippel, Diederik W.J.;
Yoo, Albert J.;
Marquering, Henk A.;
Majoie, Charles B.L.M.;
Fransen, Puck S.S.;
Beumer, Debbie;
van den Berg, Lucie A.;
Schonewille, Wouter J.;
Vos, Jan Albert;
Nederkoorn, Paul J.;
Wermer, Marieke J.H.;
Staals, Julie;
Hofmeijer, Jeannette;
van Oostayen, Jacques A.;
Lycklama à Nijeholt, Geert J.;
[...]
Value of Computed Tomographic Perfusion–Based Patient Selection for Intra-Arterial Acute Ischemic Stroke Treatment
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- Medientyp: E-Artikel
- Titel: Value of Computed Tomographic Perfusion–Based Patient Selection for Intra-Arterial Acute Ischemic Stroke Treatment
- Beteiligte: Borst, Jordi; Berkhemer, Olvert A.; Roos, Yvo B.W.E.M.; van Bavel, Ed; van Zwam, Wim H.; van Oostenbrugge, Robert J.; van Walderveen, Marianne A.A.; Lingsma, Hester F.; van der Lugt, Aad; Dippel, Diederik W.J.; Yoo, Albert J.; Marquering, Henk A.; Majoie, Charles B.L.M.; Fransen, Puck S.S.; Beumer, Debbie; van den Berg, Lucie A.; Schonewille, Wouter J.; Vos, Jan Albert; Nederkoorn, Paul J.; Wermer, Marieke J.H.; Staals, Julie; Hofmeijer, Jeannette; van Oostayen, Jacques A.; Lycklama à Nijeholt, Geert J.; [...]
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Erschienen:
Ovid Technologies (Wolters Kluwer Health), 2015
- Erschienen in: Stroke
- Sprache: Englisch
- DOI: 10.1161/strokeaha.115.010564
- ISSN: 1524-4628; 0039-2499
- Entstehung:
- Anmerkungen:
- Beschreibung: <jats:sec> <jats:title>Background and Purpose—</jats:title> <jats:p>The utility of computed tomographic perfusion (CTP)–based patient selection for intra-arterial treatment of acute ischemic stroke has not been proven in randomized trials and requires further study in a cohort that was not selected based on CTP. Our objective was to study the relationship between CTP-derived parameters and outcome and treatment effect in patients with acute ischemic stroke because of a proximal intracranial arterial occlusion.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods—</jats:title> <jats:p>We included 175 patients who underwent CTP in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN). Association of CTP-derived parameters (ischemic-core volume, penumbra volume, and percentage ischemic core) with outcome was estimated with multivariable ordinal logistic regression as an adjusted odds ratio for a shift in the direction of a better outcome on the modified Rankin Scale. Interaction between CTP-derived parameters and treatment effect was determined using multivariable ordinal logistic regression. Interaction with treatment effect was also tested for mismatch (core <70 mL; penumbra core >1.2; penumbra core >10 mL).</jats:p> </jats:sec> <jats:sec> <jats:title>Results—</jats:title> <jats:p> The adjusted odds ratio for improved functional outcome for ischemic core, percentage ischemic core, and penumbra were 0.79 per 10 mL (95% confidence interval: 0.71–0.89; <jats:italic>P</jats:italic> <0.001), 0.82 per 10% (95% confidence interval: 0.66–0.90; <jats:italic>P</jats:italic> =0.002), and 0.97 per 10 mL (96% confidence interval: 0.92–1.01; <jats:italic>P</jats:italic> =0.15), respectively. No significant interaction between any of the CTP-derived parameters and treatment effect was observed. We observed no significant interaction between mismatch and treatment effect. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>CTP seems useful for predicting functional outcome, but cannot reliably identify patients who will not benefit from intra-arterial therapy.</jats:p> </jats:sec>
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