Hypoperfusion ratio predicts infarct growth during transfer for thrombectomy. Issue 4 (23rd September 2018)

• Record Type: Journal Article
• Authors: Guenego, Adrien; Mlynash, Michael; Christensen, Soren; Kemp, Stephanie; Heit, Jeremy J.; Lansberg, Maarten G.; Albers, Gregory W.
• Is Part Of: Annals of neurology. Volume 84:Issue 4(2018)
• Page Start: 616
• Page End: 620
• Publication Date: 2018-09-23
• Subjects: Neurology -- Periodicals; Pediatric neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; 616.8
• DOI: 10.1002/ana.25320
• Languages: English
• ISSNs: 0364-5134

Abstract

Abstract : We hypothesized that automated assessment of collaterals on computed tomography perfusion can predict the rate of infarct growth during transfer from a primary to a comprehensive stroke center for endovascular stroke treatment. We identified consecutive patients (N = 28) and assessed their collaterals based on the hypoperfusion intensity ratio (HIR) prior to transfer. Infarct growth rate was strongly correlated with HIR ( r = 0.78, p < 0.001). Receiver operating characteristic analysis identified HIR ≥ 0.5 as optimal for predicting infarct growth. Patients with HIR ≥ 0.5 had a median infarct growth rate of 10.1ml/h (interquartile range [IQR] = 6.4–18.4) compared with 0.9ml/h (IQR = 0–2.8; p < 0.001) in patients with HIR < 0.5. Patients with HIR ≥ 0.5 had an 83% probability of significant core growth, whereas patients with HIR < 0.5 had an 88% probability of core stability. These preliminary data have the potential to guide decision making regarding whether repeat brain imaging should be performed after transfer to a comprehensive stroke center. Ann Neurol 2018;84:616–620