RT Journal Article
SR Electronic
T1 Value of Immediate Flat Panel Perfusion Imaging after Endovascular Therapy (AFTERMATH): A Proof of Concept Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 163
OP 170
DO 10.3174/ajnr.A8103
VO 45
IS 2
A1 Mujanovic, Adnan
A1 Kurmann, Christoph C.
A1 Manhart, Michael
A1 Piechowiak, Eike I.
A1 Pilgram-Pastor, Sara M.
A1 Serrallach, Bettina L.
A1 Boulouis, Gregoire
A1 Meinel, Thomas R.
A1 Seiffge, David J.
A1 Jung, Simon
A1 Arnold, Marcel
A1 Nguyen, Thanh N.
A1 Fischer, Urs
A1 Gralla, Jan
A1 Dobrocky, Tomas
A1 Mordasini, Pasquale
A1 Kaesmacher, Johannes
YR 2024
UL http://www.ajnr.org/content/45/2/163.abstract
AB BACKGROUND AND PURPOSE: Potential utility of flat panel CT perfusion imaging (FPCT-PI) performed immediately after mechanical thrombectomy (MT) is unknown. We aimed to assess whether FPCT-PI obtained directly post-MT could provide additional potentially relevant information on tissue reperfusion status.MATERIALS AND METHODS: This was a single-center analysis of all patients with consecutive acute stroke admitted between June 2019 and March 2021 who underwent MT and postinterventional FPCT-PI (n = 26). A core lab blinded to technical details and clinical data performed TICI grading on postinterventional DSA images and qualitatively assessed reperfusion on time-sensitive FPCT-PI maps. According to agreement between DSA and FPCT-PI, all patients were classified into 4 groups: hypoperfusion findings perfectly matched by location (group 1), hypoperfusion findings mismatched by location (group 2), complete reperfusion on DSA with hypoperfusion on FPCT-PI (group 3), and hypoperfusion on DSA with complete reperfusion on FPCT-PI (group 4).RESULTS: Detection of hypoperfusion (present/absent) concurred in 21/26 patients. Of these, reperfusion findings showed perfect agreement on location and size in 16 patients (group 1), while in 5 patients there was a mismatch by location (group 2). Of the remaining 5 patients with disagreement regarding the presence or absence of hypoperfusion, 3 were classified into group 3 and 2 into group 4. FPCT-PI findings could have avoided TICI overestimation in all false-positive operator-rated TICI 3 cases (10/26).CONCLUSIONS: FPCT-PI may provide additional clinically relevant information in a considerable proportion of patients undergoing MT. Hence, FPCT-PI may complement the evaluation of reperfusion efficacy and potentially inform decision-making in the angiography suite.AISacute ischemic strokeeTICIexpanded Thrombolysis in Cerebral InfarctionFPCT-PIflat panel CT perfusion imagingMTmechanical thrombectomyTmaxtime to maximum