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Piecing Arterial Branching Pattern Together from Non-Contrast and Angiographic Brain Computed Tomography before Endovascular Thrombectomy for Acute Ischemic Stroke

Predicting the unseen arterial course and branching pattern distal to vessel occlusion is crucial for endovascular thrombectomy in acute stroke patients. We investigated whether a comprehensive interpretation of NCT and CTA would enhance arterial course prediction more than either NCT or CTA interpr...

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Autores principales: Lee, Horyul, Shim, Woojin, Jeong, Dongjun, Kwon, Younghoon, Youn, Sung Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10298971/
https://www.ncbi.nlm.nih.gov/pubmed/37373744
http://dx.doi.org/10.3390/jcm12124051
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author Lee, Horyul
Shim, Woojin
Jeong, Dongjun
Kwon, Younghoon
Youn, Sung Won
author_facet Lee, Horyul
Shim, Woojin
Jeong, Dongjun
Kwon, Younghoon
Youn, Sung Won
author_sort Lee, Horyul
collection PubMed
description Predicting the unseen arterial course and branching pattern distal to vessel occlusion is crucial for endovascular thrombectomy in acute stroke patients. We investigated whether a comprehensive interpretation of NCT and CTA would enhance arterial course prediction more than either NCT or CTA interpretation alone. Among 150 patients who achieved post-thrombectomy TICI grades ≥ IIb for anterior circulation occlusions, we assessed visualization grade on both NCT and CTA by five scales at the thrombosed and the distal-to-thrombus segment, using DSA as the reference standard. The visualization grades were compared and related to various subgroups. The mean visualization grade of the distal-to-thrombus segment on NCT was significantly larger than that of CTA (mean ± SD, 3.62 ± 0.87 versus 3.31 ± 1.20; p < 0.05). On CTA, visualization grade of distal-to-thrombus segment in the good collateral flow subgroup was higher than that in the poor collateral flow subgroup (mean ± SD, 4.01 ± 0.93 versus 2.56 ± 0.99; p < 0.001). After the comprehensive interpretation of NCT and CTA, seventeen cases (11%) showed visualization grade of distal-to-thrombus segment upgrading. Tracing arterial course and piecing branching patterns together in distal-to-occlusion of stroke patients was feasible on the routine pre-interventional NCT and CTA, which may provide timely guidance during thrombectomy.
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spelling pubmed-102989712023-06-28 Piecing Arterial Branching Pattern Together from Non-Contrast and Angiographic Brain Computed Tomography before Endovascular Thrombectomy for Acute Ischemic Stroke Lee, Horyul Shim, Woojin Jeong, Dongjun Kwon, Younghoon Youn, Sung Won J Clin Med Article Predicting the unseen arterial course and branching pattern distal to vessel occlusion is crucial for endovascular thrombectomy in acute stroke patients. We investigated whether a comprehensive interpretation of NCT and CTA would enhance arterial course prediction more than either NCT or CTA interpretation alone. Among 150 patients who achieved post-thrombectomy TICI grades ≥ IIb for anterior circulation occlusions, we assessed visualization grade on both NCT and CTA by five scales at the thrombosed and the distal-to-thrombus segment, using DSA as the reference standard. The visualization grades were compared and related to various subgroups. The mean visualization grade of the distal-to-thrombus segment on NCT was significantly larger than that of CTA (mean ± SD, 3.62 ± 0.87 versus 3.31 ± 1.20; p < 0.05). On CTA, visualization grade of distal-to-thrombus segment in the good collateral flow subgroup was higher than that in the poor collateral flow subgroup (mean ± SD, 4.01 ± 0.93 versus 2.56 ± 0.99; p < 0.001). After the comprehensive interpretation of NCT and CTA, seventeen cases (11%) showed visualization grade of distal-to-thrombus segment upgrading. Tracing arterial course and piecing branching patterns together in distal-to-occlusion of stroke patients was feasible on the routine pre-interventional NCT and CTA, which may provide timely guidance during thrombectomy. MDPI 2023-06-14 /pmc/articles/PMC10298971/ /pubmed/37373744 http://dx.doi.org/10.3390/jcm12124051 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Horyul
Shim, Woojin
Jeong, Dongjun
Kwon, Younghoon
Youn, Sung Won
Piecing Arterial Branching Pattern Together from Non-Contrast and Angiographic Brain Computed Tomography before Endovascular Thrombectomy for Acute Ischemic Stroke
title Piecing Arterial Branching Pattern Together from Non-Contrast and Angiographic Brain Computed Tomography before Endovascular Thrombectomy for Acute Ischemic Stroke
title_full Piecing Arterial Branching Pattern Together from Non-Contrast and Angiographic Brain Computed Tomography before Endovascular Thrombectomy for Acute Ischemic Stroke
title_fullStr Piecing Arterial Branching Pattern Together from Non-Contrast and Angiographic Brain Computed Tomography before Endovascular Thrombectomy for Acute Ischemic Stroke
title_full_unstemmed Piecing Arterial Branching Pattern Together from Non-Contrast and Angiographic Brain Computed Tomography before Endovascular Thrombectomy for Acute Ischemic Stroke
title_short Piecing Arterial Branching Pattern Together from Non-Contrast and Angiographic Brain Computed Tomography before Endovascular Thrombectomy for Acute Ischemic Stroke
title_sort piecing arterial branching pattern together from non-contrast and angiographic brain computed tomography before endovascular thrombectomy for acute ischemic stroke
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10298971/
https://www.ncbi.nlm.nih.gov/pubmed/37373744
http://dx.doi.org/10.3390/jcm12124051
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