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  • Tmax profile in computed tomography perfusion-based RAPID software maps influences outcome after mechanical thrombectomy in patients with basilar artery occlusion

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Ischemic stroke
Original research
Tmax profile in computed tomography perfusion-based RAPID software maps influences outcome after mechanical thrombectomy in patients with basilar artery occlusion
  1. Xing-Long Liu,
  2. Yu Hang,
  3. Yuezhou Cao,
  4. Zhenyu Jia,
  5. Lin Bo Zhao,
  6. Hai-Bin Shi,
  7. Sheng Liu
  1. Department of Interventional Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
  1. Correspondence to Professor Sheng Liu, Interventional Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, JiangSu, China; liusheng{at}njmu.edu.cn

Abstract

Background Computed tomography perfusion (CTP) parameters have been shown to have predictive value for functional outcomes of patients with basilar artery occlusion (BAO). We report the predictive value of CTP-based software (CTP-Rapid Processing of Perfusion and Diffusion (RAPID); iSchemia View) for functional outcomes of patients with BAO after endovascular therapy (EVT).

Methods Patients with BAO who underwent EVT were retrospectively analyzed in our center from December 2019 to July 2021. Baseline characteristics and imaging parameters from non-contrast CT, CT angiography (CTA), and CTP-RAPID were collected for analysis.

Results Among the 55 patients enrolled in this study, 22 (40.0%) achieved a good functional outcome (modified Rankin Scale score ≤3 at 90 days). In the univariate analysis, posterior circulation Alberta Stroke Program Early CT Score, Basilar Artery on CT Angiography score, posterior circulation CTA score, posterior communicating artery deficiency, perfusion deficit volume in time to maximum (Tmax) >4 s, Tmax >6 s, and mismatch volume were associated with functional outcomes (all p<0.05). In the multivariate analysis, perfusion deficit volume in Tmax >6 s (OR 1.011 (95% CI 1.001 to 1.020)) and posterior circulation CTA score (OR 0.435 (95% CI 0.225 to 0.840)) remained independent outcome predictors (all p<0.05).

Conclusions Perfusion deficit volume in Tmax >6 s on CTP-RAPID imaging maps and basilar artery on CTA score have potential as functional outcome predictors in patients with BAO after EVT.

  • Stroke
  • CT perfusion
  • Thrombectomy

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/neurintsurg-2021-018557

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • X-LL and YH contributed equally.

    • Contributors X-LL and YH: acquisition of data, analysis and interpretation of data, and drafting the manuscript. H-BS and SL: study concept and design, critical revision of the manuscript for important intellectual content, and study supervision. Z-YJ, Y-ZC, and L-BZ: acquisition of data and revision of the manuscript. X-LL: statistical analysis. SL: responsible for the overall content as the guarantor.

    • Funding Project supported by the Natural Science Foundation of Jiangsu Province (BK20201088).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.