Abstract 034: Value of Immediate Flat Panel Perfusion Imaging After Endovascular Therapy: A proof of concept study
Introduction Clinical utility and diagnostic sensitivity of new‐generation flat‐panel computed tomography perfusion imaging (FPCTP) performed immediately after mechanical thrombectomy (MT) is unknown. We aimed to assess whether FPCTP obtained directly after MT could provide additional potentially re...
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| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Stroke: Vascular and Interventional Neurology |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.034 |
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| author | Adnan Mujanovic Christoph Kurmann Michael Manhart Eike Piechowiak Sara Pilgram‐Pastor Bettina Serrallach Gregoire Boulouis Thomas Meinel David Seiffge Simon Jung Marcel Arnold Thanh Nguyen Urs Fischer Jan Gralla Tomas Dobrocky Pasquale Mordasini Johannes Kaesmacher |
| author_facet | Adnan Mujanovic Christoph Kurmann Michael Manhart Eike Piechowiak Sara Pilgram‐Pastor Bettina Serrallach Gregoire Boulouis Thomas Meinel David Seiffge Simon Jung Marcel Arnold Thanh Nguyen Urs Fischer Jan Gralla Tomas Dobrocky Pasquale Mordasini Johannes Kaesmacher |
| author_sort | Adnan Mujanovic |
| collection | DOAJ |
| description | Introduction Clinical utility and diagnostic sensitivity of new‐generation flat‐panel computed tomography perfusion imaging (FPCTP) performed immediately after mechanical thrombectomy (MT) is unknown. We aimed to assess whether FPCTP obtained directly after MT could provide additional potentially relevant information on tissue reperfusion status. Methods Qualitative, single‐center analysis of all consecutive acute stroke patients admitted between 06/2019 and 03/2021 who underwent MT and post‐interventional FPCTP (n=26). A core‐lab blinded to technical details and clinical data performed reperfusion grading on post‐interventional digital subtraction angiography (DSA) images and time‐sensitive FPCTP maps. All patients were classified according to agreement between DSA and FPCTP. Results In 10/26 patients FPCTP revealed new, potentially clinically relevant information. Core‐lab adjudicated dichotomized detection of hypoperfusion (present/absent) was concurring in 21/26 (81%) patients. Of these, reperfusion findings showed perfect agreement on location and size in 16 (62%) patients, while in 5 (19%) patients with incomplete reperfusion, FPCTP showed additional hypoperfused areas missed on DSA. Of the remaining five patients subject to disagreement regarding the presence or absence of hypoperfusion, three showed complete reperfusion on DSA but hypoperfusion was noted on FPCTP, whereas two showed incomplete reperfusion on DSA without detectable hypoperfusion on FPCTP. FPCTP findings could have avoided Thrombolysis in Cerebral Infarction (TICI) overestimation in all false‐positive operator‐rated TICI3 cases. Conclusion In both core‐lab and real‐world operator assessment, FPCTP may provide additional clinically relevant information in a considerable percentage of patients undergoing MT. Hence, FPCTP may constitute a new standard for evaluating reperfusion efficacy and informed decision making in the angiography suite. |
| format | Article |
| id | doaj-art-fa4896e7d7324af4bac9d40943ba95eb |
| institution | OA Journals |
| issn | 2694-5746 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj-art-fa4896e7d7324af4bac9d40943ba95eb2025-08-20T02:26:04ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-11-013S210.1161/SVIN.03.suppl_2.034Abstract 034: Value of Immediate Flat Panel Perfusion Imaging After Endovascular Therapy: A proof of concept studyAdnan Mujanovic0Christoph Kurmann1Michael Manhart2Eike Piechowiak3Sara Pilgram‐Pastor4Bettina Serrallach5Gregoire Boulouis6Thomas Meinel7David Seiffge8Simon Jung9Marcel Arnold10Thanh Nguyen11Urs Fischer12Jan Gralla13Tomas Dobrocky14Pasquale Mordasini15Johannes Kaesmacher16University Hospital Bern Inselspital Bern SwitzerlandDepartment of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital Bern SwitzerlandSiemens Healthineers Bern SwitzerlandDepartment of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital Bern SwitzerlandDepartment of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital Bern SwitzerlandDepartment of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital Bern SwitzerlandDepartment of Diagnostic and Interventional Neuroradiology University Hospital Tours Tours FranceDepartment of Neurology University Hospital Bern Inselspital Bern SwitzerlandDepartment of Neurology University Hospital Bern Inselspital Bern SwitzerlandDepartment of Neurology University Hospital Bern Inselspital Bern SwitzerlandDepartment of Neurology University Hospital Bern Inselspital Bern SwitzerlandDepartment of Neurology Boston Medical Center Bern SwitzerlandDepartment of Neurology University Hospital Basel Basel SwitzerlandDepartment of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital Bern SwitzerlandDepartment of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital Bern SwitzerlandDepartment of Diagnostic and Interventional Neuroradiology Cantonal Hospital St. Gallen Bern SwitzerlandDepartment of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital Bern SwitzerlandIntroduction Clinical utility and diagnostic sensitivity of new‐generation flat‐panel computed tomography perfusion imaging (FPCTP) performed immediately after mechanical thrombectomy (MT) is unknown. We aimed to assess whether FPCTP obtained directly after MT could provide additional potentially relevant information on tissue reperfusion status. Methods Qualitative, single‐center analysis of all consecutive acute stroke patients admitted between 06/2019 and 03/2021 who underwent MT and post‐interventional FPCTP (n=26). A core‐lab blinded to technical details and clinical data performed reperfusion grading on post‐interventional digital subtraction angiography (DSA) images and time‐sensitive FPCTP maps. All patients were classified according to agreement between DSA and FPCTP. Results In 10/26 patients FPCTP revealed new, potentially clinically relevant information. Core‐lab adjudicated dichotomized detection of hypoperfusion (present/absent) was concurring in 21/26 (81%) patients. Of these, reperfusion findings showed perfect agreement on location and size in 16 (62%) patients, while in 5 (19%) patients with incomplete reperfusion, FPCTP showed additional hypoperfused areas missed on DSA. Of the remaining five patients subject to disagreement regarding the presence or absence of hypoperfusion, three showed complete reperfusion on DSA but hypoperfusion was noted on FPCTP, whereas two showed incomplete reperfusion on DSA without detectable hypoperfusion on FPCTP. FPCTP findings could have avoided Thrombolysis in Cerebral Infarction (TICI) overestimation in all false‐positive operator‐rated TICI3 cases. Conclusion In both core‐lab and real‐world operator assessment, FPCTP may provide additional clinically relevant information in a considerable percentage of patients undergoing MT. Hence, FPCTP may constitute a new standard for evaluating reperfusion efficacy and informed decision making in the angiography suite.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.034 |
| spellingShingle | Adnan Mujanovic Christoph Kurmann Michael Manhart Eike Piechowiak Sara Pilgram‐Pastor Bettina Serrallach Gregoire Boulouis Thomas Meinel David Seiffge Simon Jung Marcel Arnold Thanh Nguyen Urs Fischer Jan Gralla Tomas Dobrocky Pasquale Mordasini Johannes Kaesmacher Abstract 034: Value of Immediate Flat Panel Perfusion Imaging After Endovascular Therapy: A proof of concept study Stroke: Vascular and Interventional Neurology |
| title | Abstract 034: Value of Immediate Flat Panel Perfusion Imaging After Endovascular Therapy: A proof of concept study |
| title_full | Abstract 034: Value of Immediate Flat Panel Perfusion Imaging After Endovascular Therapy: A proof of concept study |
| title_fullStr | Abstract 034: Value of Immediate Flat Panel Perfusion Imaging After Endovascular Therapy: A proof of concept study |
| title_full_unstemmed | Abstract 034: Value of Immediate Flat Panel Perfusion Imaging After Endovascular Therapy: A proof of concept study |
| title_short | Abstract 034: Value of Immediate Flat Panel Perfusion Imaging After Endovascular Therapy: A proof of concept study |
| title_sort | abstract 034 value of immediate flat panel perfusion imaging after endovascular therapy a proof of concept study |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.034 |
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