Article
Clinical Neurology
Jian Miao, Hongfei Sang, Fengli Li, Jeffrey L. Saver, Bo Lei, Jinglun Li, Raul Gomes Nogueira, Bo Song, Shudong Liu, Thanh N. Nguyen, Zhenglong Jin, Hongliang Zeng, Changming Wen, Guangxiong Yuan, Weilin Kong, Weidong Luo, Shuai Liu, Dongjing Xie, Jiacheng Huang, Chang Liu, Jie Yang, Jinrong Hu, Jiaxing Song, Chengsong Yue, Linyu Li, Yan Tian, Xiao Zhang, Dan Feng, Yani Gao, Huiying Fu, Wenjie Zi, Qingwu Yang, Zhongming Qiu, Shaojun Wang
Summary: This study pooled data from two randomized clinical trials in China to assess the impact of basic imaging versus advanced imaging on clinical outcomes after endovascular thrombectomy in patients with acute ischemic stroke. The results showed no significant differences between the two imaging modalities in both the early and extended time windows.
Article
Radiology, Nuclear Medicine & Medical Imaging
Pengfei Xing, Xiaowen Zhou, Fang Shen, Yu Zhou, Hongjian Shen, Lei Zhang, Pengfei Yang, Yongwei Zhang, Jianmin Liu
Summary: This study found that patients with acute large vessel occlusion (LVO) and imaging mismatch could benefit from endovascular treatment (EVT) without increasing the risk of symptomatic intracranial hemorrhage (sICH).
EUROPEAN RADIOLOGY
(2023)
Article
Clinical Neurology
Ashutosh P. Jadhav, Mayank Goyal, Johanna Ospel, Bruce C. Campbell, Charles B. L. M. Majoie, Diederik W. Dippel, Phil White, Serge Bracard, Francis Guillemin, Antoni Davalos, Michael D. Hill, Andrew M. Demchuk, Scott Brown, Jeffrey L. Saver, Keith W. Muir, Peter Mitchell, Shashvat M. Desai, Tudor G. Jovin
Summary: This study investigated the impact of imaging selection on the outcomes of early endovascular thrombectomy (EVT) in acute ischemic stroke patients. The results showed that there was no significant difference in the rates of good functional outcomes between patients with and without baseline CTP imaging. Furthermore, EVT treatment had similar effects on patient outcomes in the 0-6 hour time window.
Article
Neuroimaging
Christoph C. Kurmann, Johannes Kaesmacher, Daniel L. Cooke, Marios Psychogios, Johannes Weber, Demetrius K. Lopes, Gregory W. Albers, Pasquale Mordasini
Summary: This study evaluated the time-resolved whole brain FD-CTP imaging and its correlation with conventional CTP imaging in qualitative and quantitative perfusion parameters. The results showed that FD-CTP can accurately predict vessel occlusion and correlate with quantitative perfusion results obtained from conventional CTP imaging.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)
Article
Neuroimaging
Rahul Rahangdale, Christopher Todd Hackett, Russell Cerejo, Nicholas M. Fuller, Konark Malhotra, Richard Williamson, Terry Hentosz, Ashis H. Tayal, Sandeep S. Rana
Summary: Nonagenarians undergoing endovascular thrombectomy (EVT) had higher mortality and symptomatic intracranial hemorrhage rates compared to younger patients, but no significant differences in successful reperfusion and functional independence were observed. Selecting nonagenarians with smaller computed tomography perfusion (CTP) predicted core volumes was associated with decreased mortality rates.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2022)
Review
Clinical Neurology
Manal Nicolas-Jilwan, Max Wintermark
Summary: Recent advancements in computed tomography technology have reinforced the importance of perfusion computed tomography imaging in evaluating patients with acute ischemic stroke, especially in selecting patients for endovascular thrombectomy. Studies have shown the benefits of perfusion imaging in diagnosing patients with anterior circulation large vessel occlusion within 24 hours. This compelling data has led to an increased introduction of automated perfusion computed tomography imaging in routine evaluation of stroke patients.
Article
Radiology, Nuclear Medicine & Medical Imaging
Xiao-Quan Xu, Gao Ma, Shan-Shan Lu, Guang-Chen Shen, Yue-Zhou Cao, Sheng Liu, Hai-Bin Shi, Fei-Yun Wu
Summary: In stroke patients achieving successful recanalization after mechanical thrombectomy, the time interval from stroke onset to computed tomography perfusion (CTP) scan and the ischemic core volume are associated with the occurrence of ghost infarct core (GIC). Patients cannot be excluded from mechanical thrombectomy solely based on baseline CTP-derived ischemic core volume, especially for patients with a shorter onset time.
EUROPEAN RADIOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Silvia Pistocchi, Davide Strambo, Bruno Bartolini, Philippe Maeder, Reto Meuli, Patrik Michel, Vincent Dunet
Summary: Different MR perfusion software can influence patient selection and clinical outcomes before EVT for AIS and LVO. The study compared two commercial MRI software methods for DWI-PWI analysis and found differences in core and hypoperfusion volumes as well as patient mismatch ratios across different time windows.
EUROPEAN RADIOLOGY
(2022)
Article
Clinical Neurology
Tobias D. Faizy, Michael Mlynash, Michael P. Marks, Soren Christensen, Reza Kabiri, Gabriella M. Kuraitis, Gabriel Broocks, Laurens Winkelmeier, Vincent Geest, Jawed Nawabi, Maarten G. Lansberg, Gregory W. Albers, Jens Fiehler, Max Wintermark, Jeremy J. Heit
Summary: The administration of tPA before endovascular thrombectomy (EVT) is associated with favorable venous outflow (VO) profiles, suggesting its potential to improve patients' venous drainage.
Article
Medicine, General & Internal
Permesh Singh Dhillon, Phil White, Mayank Goyal, Wim H. van Zwam, Robert Lenthall
Summary: Endovascular thrombectomy (EVT) is the standard of care for acute ischaemic stroke with large vessel occlusion, but adherence to strict imaging selection criteria is limited by resource constraints. Recent studies have shown that patients selected without advanced neuroimaging can still benefit from EVT treatment, leading to the need for more liberal imaging selection criteria.
Article
Neuroimaging
Guangchen He, Liming Wei, Haitao Lu, Jiangshan Deng, Feng Wang, Yueqi Zhu
Summary: Left ventricular systolic dysfunction (LVSD) can lead to overestimation of the ischemic core in patients with acute ischemic stroke (AIS), and impaired collateral status might partly mediate this effect.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)
Article
Neurosciences
Lan Hong, Longting Lin, Gang Li, Jianhong Yang, Yu Geng, Min Lou, Mark Parsons, Xin Cheng, Qiang Dong
Summary: The study aimed to develop a simple and objective score (CHESS) to identify embolic stroke with large vessel occlusions using clinical variables and quantified perfusion measures. By categorizing patients based on risk groups, it was possible to reliably determine the risk level of embolic stroke in patients.
CNS NEUROSCIENCE & THERAPEUTICS
(2022)
Article
Clinical Neurology
Tobias D. Faizy, Reza Kabiri, Soren Christensen, Michael Mlynash, Gabriella M. Kuraitis, Gabriel Broocks, Fabian Flottmann, Michael P. Marks, Maarten G. Lansberg, Gregory W. Albers, Jens Fiehler, Max Wintermark, Jeremy J. Heit
Summary: In a multicenter retrospective cohort study, favorable venous outflow in patients with acute ischemic stroke due to large vessel occlusion was found to be associated with favorable tissue-level collaterals and good functional outcomes post-treatment. Future prospective studies are needed to independently validate these findings.
Article
Medicine, General & Internal
Hongyu Gao, Yueyan Bian, Gen Cheng, Huan Yu, Yuze Cao, Huixue Zhang, Jianjian Wang, Qian Li, Qi Yang, Lihua Wang
Summary: This study developed a deep learning approach based on CTP or PWI to identify a 6-hour window for endovascular thrombectomy (EVT) in patients with acute ischemic stroke (AIS). The classifier had higher performance compared to other machine learning algorithms, and it showed potential in accurately estimating the stroke onset time of patients with wake-up stroke (WUS).
FRONTIERS IN MEDICINE
(2023)
Review
Radiology, Nuclear Medicine & Medical Imaging
Eduardo Portela de Oliveira, Jochen B. Fiebach, Achala Vagal, Pamela W. Schaefer, Richard Aviv
Summary: The development of reperfusion therapies has significantly impacted stroke care through the use of IV thrombolytic treatment and EVT, with neuroimaging playing a crucial role in patient triage and treatment selection. This article examines the use of multimodality imaging for AIS patients, highlighting controversial topics and providing guidance for clinical practice, while also reviewing major randomized trials supporting EVT. Advanced imaging is expected to further expand patient selection and treatment possibilities as ongoing studies push the boundaries of stroke care.
AMERICAN JOURNAL OF ROENTGENOLOGY
(2021)
