1. Association of critical hypoperfusion biomarkers on CT with futile recanalization and poor outcome after mechanical thrombectomy in acute ischemic stroke
- Author
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Meng Fu, Jun Yang, Xiaonan Dong, Changren Huang, Zhengzhou Yuan, Li Jiang, Renliang Meng, Yang Xie, and Jinglun Li
- Subjects
Ischemic stroke ,Anterior large-vessel occlusion ,Hypoperfusion ,Mechanical thrombectomy ,Futile recanalization ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background and purpose We aimed to investigate the association between critical perfusion delay and poor outcome among recanalized stroke patients with anterior large-vessel occlusion, and to use pretreatment hypoperfusion biomarkers on CT to predict futile recanalization even after successful thrombectomy. Methods An ischemic region with time-to-maximum (Tmax) > 12s–10s was defined as critical hypoperfusion, Tmax > 8s as moderate hypoperfusion, and hypoperfusion intensity ratio (HIR, volumetric ratio of Tmax > 10s / Tmax > 6s) represented for severity of critical hypoperfusion and rCBF 10s and > 12s (P = 0.032 and 0.008, respectively), a larger volume of ischemic core (P = 0.011) and a higher HIR (P = 0.002) than those patients achieving good outcomes. In the univariable analysis, a lower HIR (OR, 0.008; 95%CI, 0.001–0.254, P = 0.006) was associated with favorable outcome. The volume size of Tmax > 12s was significantly and positively correlated with the size of ischemic core. A HIR value higher than 0.491 might predict a futile recanalization and poor outcome (AUC = 0.701). Conclusions The critical hypoperfusion biomarkers on CTP could be useful in triaging endovascular treatment and identifying stroke patients at risk of futile recanalization.
- Published
- 2024
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