RT Journal Article
SR Electronic
T1 Prevalence of “Ghost Infarct Core” after Endovascular Thrombectomy
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 291
OP 295
DO 10.3174/ajnr.A8113
VO 45
IS 3
A1 Ospel, Johanna M.
A1 Rex, Nathaniel
A1 Rinkel, Leon
A1 Kashani, Nima
A1 Buck, Brian
A1 Rempel, Jeremy
A1 Sahlas, Demetrios
A1 Kelly, Michael E.
A1 Budzik, Ron
A1 Tymianski, Michael
A1 Hill, Michael D.
A1 Goyal, Mayank
A1 On behalf of the ESCAPE-NA1 Investigators
YR 2024
UL http://www.ajnr.org/content/45/3/291.abstract
AB BACKGROUND AND PURPOSE: Baseline CTP sometimes overestimates the size of the infarct core (“ghost core” phenomenon). We investigated how often CTP overestimates infarct core compared with 24-hour imaging, and aimed to characterize the patient subgroup in whom a ghost core is most likely to occur.MATERIALS AND METHODS: Data are from the randomized controlled ESCAPE-NA1 trial, in which patients with acute ischemic stroke undergoing endovascular treatment were randomized to intravenous nerinetide or placebo. Patients with available baseline CTP and 24-hour follow-up imaging were included in the analysis. Ghost infarct core was defined as CTP core volume minus 24-hour infarct volume > 10 mL). Clinical characteristics of patients with versus without ghost core were compared. Associations of ghost core and clinical characteristics were assessed by using multivariable logistic regression.RESULTS: A total of 421 of 1105 patients (38.1%) were included in the analysis. Forty-seven (11.2%) had a ghost core > 10 mL, with a median ghost infarct volume of 13.4 mL (interquartile range 7.6–26.8). Young patient age, complete recanalization, short last known well to CT times, and possibly male sex were associated with ghost infarct core.CONCLUSIONS: CTP ghost core occurred in ∼1 of 10 patients, indicating that CTP frequently overestimates the infarct core size at baseline, particularly in young patients with complete recanalization and short ischemia duration.AISacute ischemic strokeeTICIexpanded TICIEVTendovascular treatmentLVOlarge vessel occlusionrCBFrelative CBF