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B-0090 - Leptomeningeal score (LMs) on computed tomography angiography (CTA) and effect of endovascular reperfusion (ER) on clinical outcome in patients with acute ischaemic stroke (AIS)

E. Puglielli, R. Lattanzi, G. Esposito, V. Di Egidio; Teramo/IT Type: Scientific Paper
Area of Interests: Interventional vascular, Emergency, Neuroradiology brain
Imaging Techniques: CT-Quantitative, CT, CT-Angiography
Procedures: Efficacy studies, Computer Applications-3D, Recanalisation
Special Focuses: Image verification, Arteriosclerosis, Embolism / Thrombosis
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Purpose: A reliable noninvasive pretreatment selection criteria during AIS to improve clinical outcome after ER is still required. Aim of this study was to systematically review the importance of LMs on the outcome after ER and to evaluate a reliable score system for grading the collateral state.  [...]

Methods and materials: In our database, we identified 125 consecutive AIS patients (mean age 59,8y, April 2009-September 2016), with classic on-set, that undergoing to ET after basal CT/CTA. We assessed the baseline Alberta stroke Program Early CT Score (ASPECT) on non-enhanced (NCCT), CTA images, collaterals, clot burden[...]

Results: In our series 75/125 (60%) had a good (17-20), 41/125 (32.8%) a medium (11-16), and 9/125 (7.2%) a poor (0-10) LMs. TICI III-IIb (OR 27.50; 95%-CI 9.34-81.63) and good collaterals (OR 9.76; 95%-CI 3.28-56.72) were independent predictors of favourable outcome, such as female sex (OR 0.27; 95%-CI 3.45[...]

Conclusion: LMs alone appear to be as a strong imaging parameter for GCO after ET in AIS patients and it might be suitable for imaging based patient selection. However the effect of reperfusion on outcome seems to be strong as the LMs.  

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References: 1. Saver JL, Goyal M, van der Lugt A, et al. Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis. JAMA. 2016 Sep 27;316(12):1279-88. doi: 10.1001/jama.2016.13647.   2. Mokin M, Fargen KM, Primiani CT, et al. Vessel perforation during stent retriev[...]

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