1. Quantitative Assessment of Hyperdense Sign Measured by Hounsfield Units is Associated with Unsuccessful Mechanical Thrombectomy
- Author
-
Andres Dajles, Darko Quispe-Orozco, Fazeel M. Siddiqui, Cynthia Zevallos, Santiago Ortega-Gutierrez, Kiddy L Ume, Sudeepta Dandapat, Matthew W. Weber, and Mudassir Farooqui
- Subjects
Univariate analysis ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,Cerebral infarction ,Digital subtraction angiography ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Hounsfield scale ,Occlusion ,Angiography ,Medicine ,Radiology, Nuclear Medicine and imaging ,Neurology (clinical) ,business ,Nuclear medicine ,030217 neurology & neurosurgery ,Neuroradiology - Abstract
Despite advancement in mechanical thrombectomy (MT) techniques, 10–30% of MT for large vessel occlusions (LVO) are unsuccessful. Current prediction models fail to address the association between patient-specific factors and reperfusion. We aimed to evaluate objective, easily reproducible, admission clinical and radiological biomarkers that predict unsuccessful MT. We analyzed consecutive anterior LVO MT patients at two comprehensive stroke centers. The primary outcome was unsuccessful reperfusion defined by a modified thrombolysis in cerebral infarction (mTICI) score of 0–2a. We quantitatively assessed the hyperdense vessel sign by measuring Hounsfield units (HU) on admission computed tomography (CT). Receiver operating characteristic (ROC) curves were plotted to estimate the predictive value of quantitative hyperdense middle cerebral artery (MCA) measurements (delta and ratio) and of the final model for mTICI scores. We performed multivariable logistic regression to analyze associations with outcomes. Out of 348 patients 87 had unsuccessful MT. Smoking, difficult arch, vessel tortuosity, vessel calcification, diminutive vessels, truncal M1 occlusion, delta HU and HU ratio were significantly associated with unsuccessful MT in the univariate analysis. When we fitted two separate multivariate models including all significant variables and a HU measurement; delta HU
- Published
- 2020