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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(03): 785-794
DOI: 10.4103/ajns.AJNS_237_18
Original Article

Efficacy of computed tomography perfusion – Alberta stroke program early computed tomography score for identifying patients with anterior circulation acute ischemic stroke that would benefit from endovascular treatment

Dittapong Songsaeng
Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
,
Thewaporn Khamduang
Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
,
Thipthara Tarathipayakul
Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
,
Chulaluck Boonma
Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
,
Timo Krings
1   Division of Neuroradiology, Department of Medical Imaging, Faculty of Medicine, University of Toronto
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Background: The identification of criteria that improves the selection of ischemic stroke patients most suitable for mechanical thrombectomy (MT) will improve clinical outcomes. The aim of this study was to identify the computed tomography (CT) imaging parameter that best predicts patients who will benefit from endovascular treatment among patients with anterior circulation ischemic stroke. Materials and Methods: This retrospective study was conducted in patients with acute middle cerebral artery (MCA) stroke with/without internal carotid artery occlusion who underwent successful MT at Siriraj Hospital from November 2009 to October 2016. Evaluated parameters were compared between those with and without a favorable outcome. Results: Forty-four consecutive patients with acute MCA occlusion were included, and 61.4% had unfavorable clinical outcome. Regarding CT perfusion – Alberta stroke program early CT score (CTP-ASPECTS) at the 50% cut point, patients with favorable outcome had higher Cerebral blood volume-ASPECTS (CBV-ASPECTS) and mean transit time-ASPECTS (MTT-ASPECTS) than those with unfavorable outcome. For CTP-ASPECTS at the 75% cut point, patients with favorable outcome had higher CBV-ASPECTS, cerebral blood flow-ASPECTS, and MTT-ASPECTS than those with unfavorable outcome. Conclusions: CTP-ASPECTS at the 50% and 75% cut points of abnormality could not predict the clinical outcome of anterior ischemic stroke after thrombectomy. Of the ASPECTS evaluated in this study, MTT-ASPECTS at the 75% cut point was the most predictive parameter. Older age was associated with unfavorable outcome after thrombectomy.

Key-words:

Anterior circulation acute ischemic stroke - computed tomography perfusion-Alberta stroke program early computed tomography score - efficacy - endovascular treatment - Thailand

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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