Abstract Details

Title APECTS Predicts Favorable CT Perfusion in Anterior Circulation Strokes

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 248

Objective

Background BACKGROUND: Some centers use CTP to triage stroke patients who might benefit from endovascular therapy. There are no studies to our knowledge that identify factors associated with a favorable CTP. Those may be helpful for patients evaluated in centers where CTP is unavailable.

Design/Methods DESIGN/METHODS: We reviewed records of patients who underwent CTP between August 2010 and September 2012. We included patients with anterior circulation strokes due to large vessel occlusion 8 hours from symptom onset, who underwent a head CT and head and neck CTA as part of our protocol. Two examiners calculated the admission ASPECTS. We defined favorable CTP as a core infarct size <1/3rd of the middle cerebral artery territory distribution and a penumbra >20% of infarct size. We divided patients into two groups based on whether they had a favorable CTP or not. Risk factors, admission NIHSS, time parameters, laboratory and radiological data were compared between the groups. For statistical analysis, we used independent and Fisher's exact tests and performed multivariate logistic regression analysis.

Results RESULTS: Of 75 patients evaluated for interventional treatment, 60 had anterior circulation large vessel occlusion; 27 had a favorable CTP. Patients with favorable CTP were more likely to be ?80 years (33% vs. 9%,p=0.026), have ASPECTS >7 (81% vs. 21%,p?0.001) and lower mean time from symptom onset to CTP in minutes (234 ± 91 vs. 305 ± 122, p=0.015). On multivariate analysis, ASPECTS was the only independent predictor of a favorable CTP (OR=16.2,CI: 4.3-62.2,p<0.001).

Conclusions CONCLUSIONS: ASPECTS may be used as a tool to predict favorable CTP and select patients who may benefit from endovascular recanalization therapy in centers where CTP is unavailable. Larger studies are needed to confirm our findings.

Authors/Disclosures
Archana Hinduja, MD PRESENTER	Dr. Hinduja has nothing to disclose.
Nicolas A. Bianchi, MD (Emory University)	Dr. Bianchi has received personal compensation in the range of $0-$499 for serving as a Consultant for Innovation Hub Enterprises, LLC. The institution of Dr. Bianchi has received research support from Emory Medical Care Foundation.
	No disclosure on file
Shadi Yaghi, MD (Hackensack Meridian Health)	Dr. Yaghi has nothing to disclose.
Tuyen Ong	No disclosure on file

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