Title:Application of Computed Tomography Perfusion Imaging-guided Mechanical
Thrombectomy in Ischemic Stroke Patients with Large Vessel Occlusion beyond
the Therapeutic Time Window
Volume: 20
Author(s): Shifeng Xiang, Ya Su, Shuyuan Li, Sujun Yang and Yiping Wu*
Affiliation:
- Department of Neurology, Handan Central Hospital, Hanshan District, Handan 056001, China
Keywords:
Mechanical thrombectomy, Beyond therapeutic time window, Computed tomography, X-ray, Perfusion imaging, Stroke patients.
Abstract:
Introduction:
To explore the feasibility of applying computed tomography perfusion (CTP) imaging-guided mechanical thrombectomy in acute ischemic stroke
patients with large vessel occlusion beyond the therapeutic time window.
Methods:
The clinical data of acute cerebral infarction patients with large vessel occlusion who were beyond the therapeutic time window and admitted to
Handan Central Hospital from January 2021 to March 2022 were retrospectively analyzed. All patients were assessed by the National Institutes of
Health Stroke Scale (NIHSS) and were examined by one-stop CTP imaging. The preoperative onset time of the disease was more than 6 h.
Fourteen patients underwent magnetic resonance imaging examination at the same time. Fifty-four patients were retrospectively divided into two
groups based on the treatment methods: the mechanical thrombectomy group had 21 patients and the conservative treatment group had 33 patients.
NIHSS scoring and computed tomography scan were performed before treatment, 6 h, 24 h, 7 days, and 30 days after treatment.
Results:
The NIHSS scores of the patients with acute cerebral large vessel occlusion who underwent CTP imaging-guided mechanical thrombectomy at 6 h,
24 h, 7 days, and 30 days after treatment were compared with those of the conventional treatment group. The NIHSS score of the mechanical
thrombectomy group was significantly better, and the difference was statistically significant (P < 0.05). In terms of the prognosis rate and
expansion rate of infarct core volume, the patients of the mechanical thrombectomy group had a better prognosis, and the difference was
statistically significant (P < 0.05). Artificial intelligence-assisted CTP diagnosis can facilitate the automatic evaluation of diseases and enable quick
judgments that are independent of radiologists’ evaluation, but it may pose a problem in the determination of infarct core volume (either being too
high or too low).
Conclusion:
It is of great significance to apply CTP imaging in guiding the mechanical thrombectomy procedure in acute stroke patients with large vessel
occlusion who are beyond the therapeutic time window.