Pre-intervention cerebral blood volume predicts outcomes in patients undergoing endovascular therapy for acute ischemic stroke

Ansaar T. Rai, Karthikram Raghuram, Jeffrey S. Carpenter, Jennifer Domico, Gerald Hobbs

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Pre-intervention perfusion imaging is increasingly becoming part of stroke triage. Small studies supporting imaging based patient selection have been published. The goal of this larger study was to determine if perfusion imaging could impact on functional outcomes in patients undergoing stroke interventions. Methods: All patients who had undergone endovascular therapy for anterior circulation strokes over a 7 year period were retrospectively analyzed. The pre-intervention perfusion imaging was assessed for size of cerebral blood volume (CBV), cerebral blood flow and mean transit time (MTT) abnormalities. A perfusion mismatch for irreversible versus reversible ischemia was based on CBV and MTT. Clinical outcome and mortality were based on the 90 day modified Rankin Scale. An analysis of the pre-intervention perfusion parameters was then performed to determine any impact on functional outcomes. Results: 110 patients underwent endovascular therapy for anterior circulation strokes. A younger age and lower National Institutes of Health Stroke Scale score were important clinical predictors of favorable outcome (modified Rankin Scale ≤2). The extent of the CBV abnormality and percentage of CBV/MTT mismatch were the strongest imaging predictors of outcome and mortality. A CBV area of 229.5 mm2 (±290) was seen for favorable outcomes versus 968 mm 2 (±1173) for poor outcomes (p2 (±392) in patients without mortality versus 1401.1 mm2 (±1310) in patients with mortality (p

Original languageEnglish (US)
JournalJournal of NeuroInterventional Surgery
Volume5
Issue numberSUPPL.1
DOIs
StatePublished - May 2013
Externally publishedYes

Fingerprint

Stroke
Perfusion Imaging
Mortality
Cerebrovascular Circulation
Perfusion
Therapeutics
Triage
National Institutes of Health (U.S.)
Patient Selection
Ischemia
Cerebral Blood Volume

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Pre-intervention cerebral blood volume predicts outcomes in patients undergoing endovascular therapy for acute ischemic stroke. / Rai, Ansaar T.; Raghuram, Karthikram; Carpenter, Jeffrey S.; Domico, Jennifer; Hobbs, Gerald.

In: Journal of NeuroInterventional Surgery, Vol. 5, No. SUPPL.1, 05.2013.

Research output: Contribution to journalArticle

@article{e07e280f59584c40847c8437547b003f,
title = "Pre-intervention cerebral blood volume predicts outcomes in patients undergoing endovascular therapy for acute ischemic stroke",
abstract = "Background: Pre-intervention perfusion imaging is increasingly becoming part of stroke triage. Small studies supporting imaging based patient selection have been published. The goal of this larger study was to determine if perfusion imaging could impact on functional outcomes in patients undergoing stroke interventions. Methods: All patients who had undergone endovascular therapy for anterior circulation strokes over a 7 year period were retrospectively analyzed. The pre-intervention perfusion imaging was assessed for size of cerebral blood volume (CBV), cerebral blood flow and mean transit time (MTT) abnormalities. A perfusion mismatch for irreversible versus reversible ischemia was based on CBV and MTT. Clinical outcome and mortality were based on the 90 day modified Rankin Scale. An analysis of the pre-intervention perfusion parameters was then performed to determine any impact on functional outcomes. Results: 110 patients underwent endovascular therapy for anterior circulation strokes. A younger age and lower National Institutes of Health Stroke Scale score were important clinical predictors of favorable outcome (modified Rankin Scale ≤2). The extent of the CBV abnormality and percentage of CBV/MTT mismatch were the strongest imaging predictors of outcome and mortality. A CBV area of 229.5 mm2 (±290) was seen for favorable outcomes versus 968 mm 2 (±1173) for poor outcomes (p2 (±392) in patients without mortality versus 1401.1 mm2 (±1310) in patients with mortality (p",
author = "Rai, {Ansaar T.} and Karthikram Raghuram and Carpenter, {Jeffrey S.} and Jennifer Domico and Gerald Hobbs",
year = "2013",
month = "5",
doi = "10.1136/neurintsurg-2012-010293",
language = "English (US)",
volume = "5",
journal = "Journal of NeuroInterventional Surgery",
issn = "1759-8478",
publisher = "BMJ Publishing Group",
number = "SUPPL.1",

}

TY - JOUR

T1 - Pre-intervention cerebral blood volume predicts outcomes in patients undergoing endovascular therapy for acute ischemic stroke

AU - Rai, Ansaar T.

AU - Raghuram, Karthikram

AU - Carpenter, Jeffrey S.

AU - Domico, Jennifer

AU - Hobbs, Gerald

PY - 2013/5

Y1 - 2013/5

N2 - Background: Pre-intervention perfusion imaging is increasingly becoming part of stroke triage. Small studies supporting imaging based patient selection have been published. The goal of this larger study was to determine if perfusion imaging could impact on functional outcomes in patients undergoing stroke interventions. Methods: All patients who had undergone endovascular therapy for anterior circulation strokes over a 7 year period were retrospectively analyzed. The pre-intervention perfusion imaging was assessed for size of cerebral blood volume (CBV), cerebral blood flow and mean transit time (MTT) abnormalities. A perfusion mismatch for irreversible versus reversible ischemia was based on CBV and MTT. Clinical outcome and mortality were based on the 90 day modified Rankin Scale. An analysis of the pre-intervention perfusion parameters was then performed to determine any impact on functional outcomes. Results: 110 patients underwent endovascular therapy for anterior circulation strokes. A younger age and lower National Institutes of Health Stroke Scale score were important clinical predictors of favorable outcome (modified Rankin Scale ≤2). The extent of the CBV abnormality and percentage of CBV/MTT mismatch were the strongest imaging predictors of outcome and mortality. A CBV area of 229.5 mm2 (±290) was seen for favorable outcomes versus 968 mm 2 (±1173) for poor outcomes (p2 (±392) in patients without mortality versus 1401.1 mm2 (±1310) in patients with mortality (p

AB - Background: Pre-intervention perfusion imaging is increasingly becoming part of stroke triage. Small studies supporting imaging based patient selection have been published. The goal of this larger study was to determine if perfusion imaging could impact on functional outcomes in patients undergoing stroke interventions. Methods: All patients who had undergone endovascular therapy for anterior circulation strokes over a 7 year period were retrospectively analyzed. The pre-intervention perfusion imaging was assessed for size of cerebral blood volume (CBV), cerebral blood flow and mean transit time (MTT) abnormalities. A perfusion mismatch for irreversible versus reversible ischemia was based on CBV and MTT. Clinical outcome and mortality were based on the 90 day modified Rankin Scale. An analysis of the pre-intervention perfusion parameters was then performed to determine any impact on functional outcomes. Results: 110 patients underwent endovascular therapy for anterior circulation strokes. A younger age and lower National Institutes of Health Stroke Scale score were important clinical predictors of favorable outcome (modified Rankin Scale ≤2). The extent of the CBV abnormality and percentage of CBV/MTT mismatch were the strongest imaging predictors of outcome and mortality. A CBV area of 229.5 mm2 (±290) was seen for favorable outcomes versus 968 mm 2 (±1173) for poor outcomes (p2 (±392) in patients without mortality versus 1401.1 mm2 (±1310) in patients with mortality (p

UR - http://www.scopus.com/inward/record.url?scp=84878380500&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878380500&partnerID=8YFLogxK

U2 - 10.1136/neurintsurg-2012-010293

DO - 10.1136/neurintsurg-2012-010293

M3 - Article

VL - 5

JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

IS - SUPPL.1

ER -