دورية أكاديمية
Thrombus Attenuation Gradient Can Predict Successful First-Pass Recanalization Following Stentriever Thrombectomy.
| العنوان: | Thrombus Attenuation Gradient Can Predict Successful First-Pass Recanalization Following Stentriever Thrombectomy. |
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| المؤلفون: | Kamepalli HK; Neurointervention Center, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India., Kannath SK; Neurointervention Center, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. Electronic address: drsanthoshkannath@gmail.com., Sylaja PN; Neurointervention Center, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India., Rajan JE; Neurointervention Center, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India., Chandrasekharan K; Neurointervention Center, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. |
| المصدر: | World neurosurgery [World Neurosurg] 2024 Jan; Vol. 181, pp. e780-e788. Date of Electronic Publication: 2023 Nov 02. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York : Elsevier |
| مواضيع طبية MeSH: | Stroke*/diagnostic imaging , Stroke*/surgery , Brain Ischemia*/diagnostic imaging , Brain Ischemia*/surgery , Thrombosis*, Humans ; Treatment Outcome ; Retrospective Studies ; Thrombectomy/methods |
| مستخلص: | Objective: Computed tomography angiography (CTA) derived thrombus enhancement characteristics can predict first-pass recanalization. We studied whether dynamic contrast kinetics within the clot in multiphase CTA can predict first-pass recanalization following stentriever thrombectomy. Methods: Patients with acute large vessel occlusive stroke evaluated with multiphasic CTA who underwent stentriever thrombectomy were selected. Thrombus perviousness on various phases including arterial, venous, and delayed phases was calculated. Thrombus attenuation gradient (TAG), defined as average attenuation difference between adjacent phases, was also evaluated and correlated with successful first-pass outcome (modified Treatment in Cerebral Ischemia score ≥2b). Results: Of 69 patients, 32 (47%) had successful first-pass recanalization (group 1), and 37 (53%) required >1 attempt (group 2). TAG showed significant differences in arterial-plain and venous-arterial phases. The early increase in TAG was seen in group 1 in the arterial-plain phase, as opposed to group 2 (12.6 vs. 9, P = 0.01), which plateaued in the venous-arterial phase for group 1 and showed a further increase in group 2 (2.1 vs. 5.1, P = 0.02). A cutoff value of 9.2 HU for arterial-plain phase (P = 0.001) and 4.2 HU (P = 0.001) for venous-arterial phase was predictive of first-pass effect. Combining 2 metrics had an odds ratio of 2.8 for first-pass recanalization (P = 0.035). Accuracy evaluated in a validation cohort yielded 74%. Other features including histology were not significant. Conclusions: TAG evaluated from multiphase CTA can predict first-pass effect in stentriever thrombectomy. (Copyright © 2023 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: First pass recanalization; Multiphasic computed tomography angiography; Thrombus attenuation gradient; Thrombus enhancement |
| تواريخ الأحداث: | Date Created: 20231104 Date Completed: 20240118 Latest Revision: 20240628 |
| رمز التحديث: | 20240629 |
| DOI: | 10.1016/j.wneu.2023.10.126 |
| PMID: | 37925151 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1878-8769 |
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| DOI: | 10.1016/j.wneu.2023.10.126 |