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Czech National Centre for Evidence Ba... 1 Department of Clinical Neurosciences ... 1 Department of Clinical Neurosciences ... 1 Department of Community Health Scienc... 1 Department of Experimental and Clinic... 1 Department of Medicine University of ... 1 Department of Neurology Hospital Vall... 1 Department of Neurology University Ho... 1 Department of Radiology University Ho... 1 Department of Radiology University of... 1 Department of Radiology University of... 1 Hotchkiss Brain Institute University ... 1
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Czech National Centre for Evidence Ba... 1 Department of Clinical Neurosciences ... 1 Department of Clinical Neurosciences ... 1 Department of Community Health Scienc... 1 Department of Experimental and Clinic... 1 Department of Medicine University of ... 1 Department of Neurology Hospital Vall... 1 Department of Neurology University Ho... 1 Department of Radiology University Ho... 1 Department of Radiology University of... 1 Department of Radiology University of... 1 Hotchkiss Brain Institute University ... 1
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- Ospel, Johanna M
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Volny, Ondrej
Autor Volny, Ondrej Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic Department of Neurology, University Hospital Ostrava, Ostrava-Poruba, Czech Republic
- Qiu, Wu
- Najm, Mohamed
- Hafeez, Moiz
- Abdalrahman, Sarah
- Fainardi, Enrico
- Rubiera, Marta
- Khaw, Alexander
- Shankar, Jai J
Free Medical Journals od 2013
PubMed Central od 2013
Europe PubMed Central od 2013
Open Access Digital Library od 2013-01-01
ROAD: Directory of Open Access Scholarly Resources od 2013
PubMed
34649382
DOI
10.5853/jos.2021.00619
Knihovny.cz E-zdroje
BACKGROUND AND PURPOSE: Various imaging paradigms are used for endovascular treatment (EVT) decision-making and outcome estimation in acute ischemic stroke (AIS). We aim to compare how these imaging paradigms perform for EVT patient selection and outcome estimation. METHODS: Prospective multi-center cohort study of patients with AIS symptoms with multi-phase computed tomography angiography (mCTA) and computed tomography perfusion (CTP) baseline imaging. mCTA-based EVT-eligibility was defined as presence of large vessel occlusion (LVO) and moderate-to-good collaterals on mCTA. CTP-based eligibility was defined as presence of LVO, ischemic core (defined on relative cerebral blood flow, absolute cerebral blood flow, and cerebral blood volume maps) <70 mL, mismatch-ratio >1.8, absolute mismatch >15 mL. EVT-eligibility and adjusted rates of good outcome (modified Rankin Scale 0-2) based on these imaging paradigms were compared. RESULTS: Of 289/464 patients with LVO, 263 (91%) were EVT-eligible by mCTA-criteria versus 63 (22%), 19 (7%) and 103 (36%) by rCBF, aCBF, and CBV-CTP-criteria. CTP and mCTA-criteria were discordant in 40% to 53%. Estimated outcomes were best in patients who met both mCTA and CTP eligibility-criteria and were treated with EVT (62% to 87% good outcome). Patients eligible for EVT by mCTA-criteria and not by CTP-criteria receiving EVT achieved good outcome rates of 53% to 57%. Few patients met CTP-criteria and not mCTA-criteria for EVT. CONCLUSIONS: Simpler imaging selection criteria that rely on little else than detection of the occluded blood vessel may be more sensitive and less specific, thus resulting in more patients being offered EVT and arguably benefiting from it.
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Po ukončení testovacího provozu bude odkaz přesměrován adresu produkční verze portálu Medvik.