PT  - JOURNAL ARTICLE
AU  - Zeguang Ren
AU  - Gaoting Ma
AU  - Maxim Mokin
AU  - Ashutosh P Jadhav
AU  - Baixue Jia
AU  - Xu Tong
AU  - Clayton Bauer
AU  - Raynald Liu
AU  - Anxin Wang
AU  - Xuelei Zhang
AU  - Dapeng Mo
AU  - Ning Ma
AU  - Feng Gao
AU  - Ligang Song
AU  - Xuan Sun
AU  - Xiaochuan Huo
AU  - Yiming Deng
AU  - Lian Liu
AU  - Gang Luo
AU  - Xiang Luo
AU  - Ya Peng
AU  - Liqiang Gui
AU  - Cunfeng Song
AU  - Jin Wu
AU  - Leyuan Wang
AU  - Chunlei Li
AU  - Tudor G Jovin
AU  - Yilong Wang
AU  - Yongjun Wang
AU  - Zhongrong Miao
ED  - ,
TI  - Non-contrast head CT alone for thrombectomy in acute ischemic stroke: analysis of the ANGEL-ACT registry
AID  - 10.1136/neurintsurg-2021-017940
DP  - 2021 Oct 01
TA  - Journal of NeuroInterventional Surgery
PG  - neurintsurg-2021-017940
4099  - http://jnis.bmj.com/content/early/2021/10/01/neurintsurg-2021-017940.short
4100  - http://jnis.bmj.com/content/early/2021/10/01/neurintsurg-2021-017940.full
AB  - Backgroud The goal of this study was to determine if the choice of imaging paradigm performed in the emergency department influences the procedural or clinical outcomes after mechanical thrombectomy (MT).Methods This is a retrospective comparative outcome study which was conducted from the ANGEL-ACT registry. Comparisons were made between baseline characteristics and clinical outcomes of patients with acute ischemic stroke undergoing MT with non-contrast head computed tomography (NCHCT) alone versus patients undergoing NCHCT plus non-invasive vessel imaging (NVI) (including CT angiography (with or without CT perfusion) and magnetic resonance angiography). The primary outcome was the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes included change in mRS score from baseline to 90 days, the proportions of mRS 0–1, 0–2, and 0–3, and dramatic clinical improvement at 24 hours. The safety outcomes were any intracranial hemorrhage (ICH), symptomatic ICH, and mortality within 90 days.Results A total of 894 patients met the inclusion criteria; 476 (53%) underwent NCHCT alone and 418 (47%) underwent NCHCT + NVI. In the NCHCT alone group, the door-to-reperfusion time was shorter by 47 min compared with the NCHCT + NVI group (219 vs 266 min, P<0.001). Patients in the NCHCT alone group showed a smaller increase in baseline mRS score at 90 days (median 3 vs 2 points; P=0.004) after adjustment. There were no significant differences between groups in the remaining clinical outcomes.Conclusions In patients selected for MT using NCHCT alone versus NCHCT + NVI, there were improved procedural outcomes and smaller increases in baseline mRS scores at 90 days.Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information. Data are available to researchers on request for purposes of reproducing the results or replicating the procedure by directly contacting the corresponding author.