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Abstract Details

Computed Tomography Perfusion provides clinically relevant core infarct for thrombectomy selection
Cerebrovascular Disease and Interventional Neurology
P5 - Poster Session 5 (5:30 PM-6:30 PM)
3-052
To evaluate the accuracy of CT Perfusion in predicting core infarct volume in acute setting for thrombectomy selection. 

Infarct core assessment on presentation is important to evaluate the amount of salvageable tissue to select patients for thrombectomy. Our study aims to measure the correlation of infarct core volume on CTP with magnetic resonance (MR) diffusion weighted imaging (DWI) in patients with acute large-vessel occlusion.

We studied patients who underwent CTP on presentation to emergency department for stroke symptoms. Patient baseline characteristics NIHSS, collateral status, symptomatic vessels and modified rankin scale (mRS) at 90-days were collected. Admission infarct core was measured on initial cerebral blood volume (CBV) and final infarct on follow-up DWI. The level of agreement between two measures was assessed using the Bland Altman plot.


74 patients were studied of which 41% were female. Median National Institutes of Health Stroke Scale (NIHSS) score was 13 (2-30). Middle Cerebral artery occlusion was present in 53 (71.6%) patients and 54 (73%) had good collaterals. Good functional outcome of mRS 0-2 was achieved by 45% at 90 days. Median infarct core on CTP was 55 mL (10-320). Final infarct volume on DWI was 45 mL (15-320). CTP overestimated the infarct core by 10.3 mL (p=0.038) as compared to DWI. This difference was augmented in patients with core volume of more than 100 mL.
CT Perfusion overestimates the core infarct volume for larger core volumes. However, it performs well within the clinically relevant thresholds of patient selection for thrombectomy.
Authors/Disclosures
Hussam Shaker, MD (C&RMEP)
PRESENTER 		Dr. Shaker has nothing to disclose.
Muhib Khan, MD, FAAN (Mayo Clinic) The institution of Dr. Khan has received research support from Mayo Clinic 好色先生 Grant . The institution of Dr. Khan has received research support from Mayo Clinic Small Grants .
No disclosure on file
Tracy J. Koehler Tracy J. Koehler has nothing to disclose.
No disclosure on file
No disclosure on file
Jiangyong Min, MD (Corewell Health West) Dr. Min has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic . Dr. Min has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for CredentialMed, LLC. The institution of Dr. Min has received research support from Corerwell Health Foundation .
Nabil Wees, MD (Augusta University) Dr. Wees has nothing to disclose.
Nadeem I. Khan, MD (Spectrum Health) Dr. Khan has nothing to disclose.
Tamer Abdelhak, MD (Albany Medical College) Dr. Abdelhak has nothing to disclose.