Clinical application of CT angiography in acute ischemic stroke

Verro, Piero; Tanenbaum, Lawrence N.; Borden, Neil M.; Eshkar, Noam; Sen, Souvik

doi:10.1016/j.clineuro.2006.07.002

Cited by 18 publications

(11 citation statements)

References 17 publications

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“…Large-vessel occlusions and poor collateral vessels on CTA have been demonstrated to be associated with an increased rate of HT and poor clinical outcomes [5,6,7]. PCT can distinguish between the infarct core and the penumbra using quantitative assessments of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT).…”

Section: Introductionmentioning

confidence: 99%

Increased Blood-Brain Barrier Permeability on Perfusion Computed Tomography Predicts Hemorrhagic Transformation in Acute Ischemic Stroke

et al. 2014

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Background/Purpose: Perfusion computed tomography (CT) is capable of measuring the permeability surface product (PS). PS reflects the permeability of the blood-brain barrier, involved in the pathophysiology of hemorrhagic transformation (HT) of ischemic stroke. The aim of our study was to determine if an increased PS can predict HT. Methods: A total of 86 patients with ischemic stroke were included. They underwent multimodality CT, including the measurement of PS. We compared the clinical and radiological characteristics of patients who developed HT to those who did not, using univariate analysis. Multivariate regression analyses were then used to determine HT predictors. Results: HT was observed in 27 patients (31%). Infarct PS was significantly associated with HT (p = 0.047), as were atrial fibrillation (p = 0.03), admission National Institute of Health Stroke Scale score (p = 0.02), infarct volume (p = 0.0004), presence of large-vessel occlusion (p = 0.0005) and a poorer collateral status (p = 0.003). Using logistic regression modeling, an infarct PS >0.84 ml/100 g/min was an independent predictor of HT (OR 28, 95% CI 1.75-452.98; p = 0.02). Other independent predictors of HT were infarct volume and a history of atrial fibrillation. Conclusions: Our findings suggest thatinfarct PS can be a predictor of HT and may help clinicians to improve patient care around thrombolysis decisions in the acute phase of ischemic stroke.

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Section: Introductionmentioning

confidence: 99%

Increased Blood-Brain Barrier Permeability on Perfusion Computed Tomography Predicts Hemorrhagic Transformation in Acute Ischemic Stroke

et al. 2014

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“…Dynamic CT perfusion (CTP) differentiates thresholds of reversible and irreversible ischemia and, thus, helps to identify "tissue at risk" that is potentially salvageable with thrombolytic therapy. [1][2][3][4] CT angiography (CTA) allows for rapid noninvasive assessment of the intracranial and extracranial vasculature and identifies vessel occlusions or stenoses that may be amenable to acute treatment. [1][2][3][4] For intracerebral hemorrhage, CTA can identify secondary causes of hemorrhage, and, in the acute phase, the CTA "spot sign" can predict which hemorrhages are likely to expand.…”

mentioning

confidence: 99%

“…[1][2][3][4] CT angiography (CTA) allows for rapid noninvasive assessment of the intracranial and extracranial vasculature and identifies vessel occlusions or stenoses that may be amenable to acute treatment. [1][2][3][4] For intracerebral hemorrhage, CTA can identify secondary causes of hemorrhage, and, in the acute phase, the CTA "spot sign" can predict which hemorrhages are likely to expand. [5][6][7] Advantages of multimodal CT over MR imaging include its rapid accessibility, lower costs, shorter scanning time intervals, better patient tolerability, and higher spatial resolution.…”

mentioning

confidence: 99%

Renal Safety of CT Angiography and Perfusion Imaging in the Emergency Evaluation of Acute Stroke

Hopyan¹,

Gladstone²,

Mallia³

et al. 2008

AJNR Am J Neuroradiol

120

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BACKGROUND AND PURPOSE:Multimodal CT imaging with contrast-enhanced CT angiography (CTA) and CT perfusion (CTP) is increasingly being used to guide emergency management of acute stroke. However, little has been reported about the safety of intravenous contrast administration associated with these studies in the acute stroke population, including cases in which baseline creatinine values are unknown. We investigated the incidence of contrast-induced nephropathy (CIN), defined as a 25% or more increase in baseline creatinine levels within 72 hours of contrast administration and chronic kidney disease in patients receiving CTAϮCTP at our regional stroke center.

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“…1 Investigators improved predictive power by supplementing the NIHSS with MR imaging, sonography, and CTA data. [11][12][13][14] However, clinical classification instruments are limited in their ability to assess the effects of treatments on arterial occlusions, and they provide little guidance on how therapy may be improved. 2 Stroke classification instruments based on imaging alone have been proposed, 5,9,13,15 including CTA source image data 16 and CTA.…”

Section: Stroke Classification Instruments and Basismentioning

confidence: 99%

An Acute Ischemic Stroke Classification Instrument That Includes CT or MR Angiography: The Boston Acute Stroke Imaging Scale

Torres-Mozqueda

He²,

Yeh³

et al. 2008

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:A simple classification instrument based on imaging that predicts outcomes in patients with actute ischemic stroke is lacking. We tested the hypotheses that the Boston Acute Stroke Imaging Scale (BASIS) classification instrument effectively predicts patient outcomes and is superior to the Alberta Stroke Program Early CT Score (ASPECTS) in predicting outcomes in acute ischemic stroke.

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Clinical application of CT angiography in acute ischemic stroke

Cited by 18 publications

References 17 publications

Increased Blood-Brain Barrier Permeability on Perfusion Computed Tomography Predicts Hemorrhagic Transformation in Acute Ischemic Stroke

Increased Blood-Brain Barrier Permeability on Perfusion Computed Tomography Predicts Hemorrhagic Transformation in Acute Ischemic Stroke

Renal Safety of CT Angiography and Perfusion Imaging in the Emergency Evaluation of Acute Stroke

An Acute Ischemic Stroke Classification Instrument That Includes CT or MR Angiography: The Boston Acute Stroke Imaging Scale

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