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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(04): 1126-1133
DOI: 10.4103/ajns.AJNS_242_19
Original Article

Value of brain computed tomographic angiography to predict post thrombectomy final infarct size and clinical outcome in acute ischemic stroke

Mungkorn Apirakkan
0   Division of Interventional Neuroradiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok
,
Withawat Vuthiwong
0   Division of Interventional Neuroradiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok
,
Chai Kobkitsuksakul
0   Division of Interventional Neuroradiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok
,
Jesada Keandoungchun
1   Division of Neurology, Department of Internal Medicine, Ramathibodi Hospital, Mahidol University, Bangkok
,
Ekachat Chanthanaphak
0   Division of Interventional Neuroradiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok
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Aims: This study aims to analyze the predictor in preoperative brain computed tomographic angiography (CTA) for final infarct and outcome in postendovascular thrombectomy patient. Subjects and Methods: 52 patients were retrospectively reviewed. The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) comparison between preoperative noncontrast computed tomography (NCCT) and 24-h NCCT as well as preoperative CTA source image (CTA-SI) and 24-h NCCT were performed. Factors associated with increased ASPECTS and clinical outcome were evaluated. Results: Preoperative NCCT ASPECTS = 24-h NCCT in 23%. Whereas, 46% showed preoperative CTA-SI ASPECTS = 24-h NCCT. Moreover, 40.4% showed 24-h NCCT ASPECTS > preoperative CTA-SI (increased ASPECTS). The two significant factors associated with increased ASPECTS are thrombolysis in cerebral infarct score 2b/3 (P = 0.02) and good collateral status (P = 0.02). Finally, good clinical outcome was associated with age <60 (P = 0.04), preoperative CTA-SI ASPECTS >5 (P = 0.01), good collaterals status (P = 0.02), and increased ASPECTS (P = 0.05). Conclusions: Preoperative brain CTA provided the necessary factors that are associated with good clinical outcomes, which are CTA-SI ASPECTS > 5, good collateral status, and increased ASPECTS.

Key-words:

Computed tomographic angiography source image Alberta Stroke Program Early Computed Tomography Score - final infarct volume - increase Alberta Stroke Program Early Computed Tomography Score - stroke outcome

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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