RT Journal Article
SR Electronic
T1 Non-contrast head CT alone for thrombectomy in acute ischemic stroke: analysis of the ANGEL-ACT registry
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 868
OP 874
DO 10.1136/neurintsurg-2021-017940
VO 14
IS 9
A1 Ren, Zeguang
A1 Ma, Gaoting
A1 Mokin, Maxim
A1 Jadhav, Ashutosh P
A1 Jia, Baixue
A1 Tong, Xu
A1 Bauer, Clayton
A1 Liu, Raynald
A1 Wang, Anxin
A1 Zhang, Xuelei
A1 Mo, Dapeng
A1 Ma, Ning
A1 Gao, Feng
A1 Song, Ligang
A1 Sun, Xuan
A1 Huo, Xiaochuan
A1 Deng, Yiming
A1 Liu, Lian
A1 Luo, Gang
A1 Luo, Xiang
A1 Peng, Ya
A1 Gui, Liqiang
A1 Song, Cunfeng
A1 Wu, Jin
A1 Wang, Leyuan
A1 Li, Chunlei
A1 Jovin, Tudor G
A1 Wang, Yilong
A1 Wang, Yongjun
A1 Miao, Zhongrong
A1 ,
YR 2022
UL http://jnis.bmj.com/content/14/9/868.abstract
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.