View in EDS

DSA-based perfusion parameters versus TICI score after mechanical thrombectomy in acute ischaemic stroke patients: a congruence analysis

Saved in:
Bibliographic Details
Title: DSA-based perfusion parameters versus TICI score after mechanical thrombectomy in acute ischaemic stroke patients: a congruence analysis
Authors: Sebastian R. Reder, Andrea Kronfeld, Sonja Gröschel, Arda Civelek, Klaus Gröschel, Marc A. Brockmann, Timo Uphaus, Marianne Hahn, Carolin Brockmann, Ahmed E. Othman
Contributors: Johannes Gutenberg-Universität Mainz
Source: Eur Radiol Exp
European Radiology Experimental, Vol 8, Iss 1, Pp 1-19 (2024)
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Male, Aged, 80 and over, Ischemic stroke, 610 Medizin, R895-920, Angiography, Digital Subtraction, Contrast Media, Middle Aged, Perfusion imaging, Angiography (digital subtraction), Medical physics. Medical radiology. Nuclear medicine, 03 medical and health sciences, Treatment Outcome, 0302 clinical medicine, Female [MeSH], Ischemic Stroke/surgery [MeSH], Outcome, Aged, 80 and over [MeSH], Aged [MeSH], Thrombectomy/methods [MeSH], Humans [MeSH], Treatment Outcome [MeSH], Middle Aged [MeSH], Contrast Media [MeSH], Original Article, Male [MeSH], Thrombectomy, Ischemic Stroke/diagnostic imaging [MeSH], Angiography, Digital Subtraction/methods [MeSH], Ischemic Stroke/physiopathology [MeSH], 610 Medical sciences, Humans, Female, Aged, Ischemic Stroke
Description: Background Several factors are frequently considered for outcome prediction rin stroke patients. We assessed the value of digital subtraction angiography (DSA)-based brain perfusion measurements after mechanical thrombectomy (MT) for outcome prediction in acute ischaemic stroke. Methods From DSA image data (n = 90; 38 females; age 73.3 ± 13.1 years [mean ± standard deviation]), time-contrast agent (CA) concentration curves were acquired, and maximum slope (MS), time to peak (TTP), and maximum CA concentration (CAmax) were calculated using an arterial input function. This data was used to predict neurological deficits at 24 h and upon discharge by using multiple regression analysis; the predictive capability was compared with the predictive power of the “Thrombolysis in cerebral infarction” (TICI) score. Intraclass correlation coefficients (ICC) of the NIHSS values were analysed. Results The comparison of means revealed a linear trend after stratification into TICI classes for CAmax (TICI 0: 0.07 ± 0.02 a.u. to TICI 3: 0.22 ± 0.07 a.u.; p p R² ~ 0.03). Compared to the actual NIHSS, the ICC ranged from 0.55 to 0.84 for DSA-based models and from 0.6 to 0.82 for TICI-based models. Conclusion Semi-quantitative evaluation of DSA-based perfusion parameters prior to and after MT is feasible and could enhance the objectivity and comparability of MT outcome prediction. This technique may offer novel approaches in acute ischaemic stroke management and data comparability. Relevance statement DSA-based brain perfusion measurements following interventional stroke therapy could allow for an experience-independent assessment of reperfusion success. It demonstrates predictive power at least equivalent to the established methods. This could support a future automated DSA-based brain perfusion measurement method. Key Points Currently, the evaluation of stroke therapy success is based on the treating physician’s experience. The present study introduces an objective semi-quantitative evaluation method. In predicting clinical outcomes, the traditional expert-based and semi-quantitative methods are equivalent. Graphical Abstract
Document Type: Article
Other literature type
Language: English
ISSN: 2509-9280
DOI: 10.1186/s41747-024-00534-1
DOI: 10.25358/openscience-12012
Access URL: https://pubmed.ncbi.nlm.nih.gov/39636547
https://doaj.org/article/02de84ee91c74765a0d77aa5e88d76d9
https://openscience.ub.uni-mainz.de/handle/20.500.12030/12033
https://doi.org/10.25358/openscience-12012
https://repository.publisso.de/resource/frl:6515649
Rights: CC BY
Accession Number: edsair.doi.dedup.....1fdbef5bc21a73ab1d59de0308aa60b4
Database: OpenAIRE
Description
Abstract:Background Several factors are frequently considered for outcome prediction rin stroke patients. We assessed the value of digital subtraction angiography (DSA)-based brain perfusion measurements after mechanical thrombectomy (MT) for outcome prediction in acute ischaemic stroke. Methods From DSA image data (n = 90; 38 females; age 73.3 ± 13.1 years [mean ± standard deviation]), time-contrast agent (CA) concentration curves were acquired, and maximum slope (MS), time to peak (TTP), and maximum CA concentration (CAmax) were calculated using an arterial input function. This data was used to predict neurological deficits at 24 h and upon discharge by using multiple regression analysis; the predictive capability was compared with the predictive power of the “Thrombolysis in cerebral infarction” (TICI) score. Intraclass correlation coefficients (ICC) of the NIHSS values were analysed. Results The comparison of means revealed a linear trend after stratification into TICI classes for CAmax (TICI 0: 0.07 ± 0.02 a.u. to TICI 3: 0.22 ± 0.07 a.u.; p p R² ~ 0.03). Compared to the actual NIHSS, the ICC ranged from 0.55 to 0.84 for DSA-based models and from 0.6 to 0.82 for TICI-based models. Conclusion Semi-quantitative evaluation of DSA-based perfusion parameters prior to and after MT is feasible and could enhance the objectivity and comparability of MT outcome prediction. This technique may offer novel approaches in acute ischaemic stroke management and data comparability. Relevance statement DSA-based brain perfusion measurements following interventional stroke therapy could allow for an experience-independent assessment of reperfusion success. It demonstrates predictive power at least equivalent to the established methods. This could support a future automated DSA-based brain perfusion measurement method. Key Points Currently, the evaluation of stroke therapy success is based on the treating physician’s experience. The present study introduces an objective semi-quantitative evaluation method. In predicting clinical outcomes, the traditional expert-based and semi-quantitative methods are equivalent. Graphical Abstract
ISSN:25099280
DOI:10.1186/s41747-024-00534-1