دورية أكاديمية
Computed Tomographic Perfusion Predicts Poor Outcomes in a Randomized Trial of Endovascular Therapy.
| العنوان: | Computed Tomographic Perfusion Predicts Poor Outcomes in a Randomized Trial of Endovascular Therapy. |
|---|---|
| المؤلفون: | Wannamaker, Robert, Guinand, Taurian, Menon, Bijoy K, Demchuk, Andrew, Goyal, Mayank, Frei, Donald, Bharatha, Aditya, Jovin, Tudor G, Shankar, Jai, Krings, Timo, Baxter, Blaise W, MD, Holmstedt, Christine, Swartz, Richard, Dowlatshahi, Dar, Chan, Richard, Tampieri, Donatella, Choe, Hana, Burns, Paul, Gentile, Nina, Rempel, Jeremy, Shuaib, Ashfaq, Buck, Brian, Bivard, Andrew, Hill, Michael, Butcher, Kenneth |
| المصدر: | Department of Radiology & Diagnostic Medical Imaging |
| بيانات النشر: | LVHN Scholarly Works |
| سنة النشر: | 2018 |
| المجموعة: | Lehigh Valley Health Network: LVHN Scholarly Works |
| مصطلحات موضوعية: | Aged, 80 and over, Brain Ischemia, Endovascular Procedures, Female, Fibrinolytic Agents, Humans, Male, Middle Aged, Predictive Value of Tests, Randomized Controlled Trials as Topic, Stroke, Thrombectomy, Tissue Plasminogen Activator, Tomography, X-Ray Computed, Treatment Outcome, Department of Radiology and Diagnostic Medical Imaging, Diagnosis, Medicine and Health Sciences, Other Analytical, Diagnostic and Therapeutic Techniques and Equipment, Radiology |
| الوصف: | BACKGROUND AND PURPOSE: In the ESCAPE trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion with Emphasis on Minimizing CT to Recanalization Times), patients with large vessel occlusions and small infarct cores identified with computed tomography (CT)/CT angiography were randomized to endovascular therapy or standard of care. CT perfusion (CTP) was obtained in some cases but was not used to select patients. We tested the hypothesis that patients with penumbral CTP patterns have higher rates of good clinical outcome. METHODS: All CTP data acquired in ESCAPE patients were analyzed centrally using a semiautomated perfusion threshold-based approach. A penumbral pattern was defined as an infarct core <70 >mL, penumbral volume >15 mL, and a total hypoperfused volume:core volume ratio of >1.8. The primary outcome was good functional outcome at 90 days (modified Rankin Scale score, 0-2). RESULTS: CTP was acquired in 138 of 316 ESCAPE patients. Penumbral patterns were present in 116 of 128 (90.6%) of patients with interpretable CTP data. The rate of good functional outcome in penumbral pattern patients (53 of 114; 46%) was higher than that in nonpenumbral patients (2 of 12; 17%; CONCLUSIONS: The majority of patients with CTP imaging in the ESCAPE trial had penumbral patterns, which were associated with better outcomes overall. Patients with penumbra treated with endovascular therapy had the greatest odds of good functional outcome. Nonpenumbral patients were much less likely to achieve good outcomes. |
| نوع الوثيقة: | text |
| اللغة: | unknown |
| العلاقة: | https://scholarlyworks.lvhn.org/radiology-diagnostic-medical-imaging/379Test; https://pubmed.ncbi.nlm.nih.gov/29739914Test/ |
| الإتاحة: | https://scholarlyworks.lvhn.org/radiology-diagnostic-medical-imaging/379Test https://pubmed.ncbi.nlm.nih.gov/29739914Test/ |
| رقم الانضمام: | edsbas.D791F9B3 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |