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

• Published in: Asian journal of neurosurgery Vol. 14; no. 4; pp. 1126 - 1133
• Main Authors: Apirakkan, Mungkorn, Vuthiwong, Withawat, Kobkitsuksakul, Chai, Keandoungchun, Jesada, Chanthanaphak, Ekachat
• Format: Journal Article
• Language: English
• Published: A-12, 2nd Floor, Sector 2, Noida-201301 UP, India Thieme Medical and Scientific Publishers Pvt. Ltd 01.10.2019; Wolters Kluwer India Pvt. Ltd; Wolters Kluwer - Medknow
• Subjects: Original; Original Article; Computed tomographic angiography source image Alberta Stroke Program Early Computed Tomography Score; increase Alberta Stroke Program Early Computed Tomography Score; stroke outcome; final infarct volume
• ISSN: 1793-5482; 2248-9614
• DOI: 10.4103/ajns.AJNS_242_19

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.