Perfusion ct based thrombolysis in acute ischaemic stroke

Details

Serval ID
serval:BIB_296B26EB426D
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Perfusion ct based thrombolysis in acute ischaemic stroke
Title of the conference
ABN joint annual meeting with the neurology section of the Cuban Society of Neurology and Neurosurgery
Author(s)
Agarwal S., Jones P. S., Scoffings D. J., Alawaneh J., Barry P. J., O'Brien E. W., Carrera E., Cotter P. E., Baron J. C., Warburton E. A.
Address
4-6 April 2011
ISBN
0022-3050
Publication state
Published
Issued date
2011
Volume
82
Series
Journal of Neurology Neurosurgery and Psychiatry
Pages
-
Language
english
Notes
Publication type : Meeting Abstract
Abstract
Background Despite use in clinical practice and trials of thrombolysis, a non-contrast CT is not sensitive for identifying penumbral tissue in acute stroke. This study evaluated how it compares with physiological imaging using CT perfusion.Methods 40 imaging datasets with non-contrast CT (NCCT) and perfusion CT (CTP) were retrospectively identified. 2 sets of observers (n¼6) and a neuroradiologist made a blind evaluation of the images. Inter-observer agreement was calculated for identifying ischaemic change on NCCT, and abnormalities on cerebral blood flow, time to peak and cerebral blood volume maps. A prospective cohort of 73 patients with anterior circulation cortical strokes were thrombolysed based on qualitative assessment of penumbral tissue on CTP within 3 h of stroke onset. Functional outcome was assessed at 3 months.Results Inter-rater agreement was moderate (k¼0.54) for early ischaemic change on NCCT. Perfusion maps improved this to substantial for deficit in cerebral blood volume (k¼0.67) and almost perfect for time to peak and cerebral blood flow (both k¼0.87). In the prospective arm, 58.9% of patients with cortical strokes were thrombolysed. There was no significant difference in attainment of complete recovery (p¼0.184) between the thrombolysed and nonthrombolysed group.Conclusions We demonstrate how perfusion CT aids clinical decision- making in acute stroke. Good functional outcomes from thrombolysis can be safely achieved using this physiologically informed approach.
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Create date
01/09/2011 12:32
Last modification date
20/08/2019 13:09
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