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Penumbral Imaging to Guide Endovascular Treatment for M2 Middle Cerebral Artery Stroke.
Stroke
January 2025
Department of Diagnostic and Interventional Neuroradiology (G.B., M.M., M.B., H.K., L.W., C.H., J.F., L.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Background: A potential benefit of mechanical thrombectomy for patients with distal medium vessel occlusions is currently being investigated in randomized trials. Computed tomography perfusion imaging has not yet been tested as a method to guide mechanical thrombectomy for distal medium vessel occlusions. The purpose of this study was to assess penumbral imaging as an imaging-based method for triaging patients with ischemic stroke and acute M2-middle cerebral artery occlusion.
View Article and Find Full Text PDFThrombectomy in ischemic stroke patients with large core but minor ischemic changes on non-enhanced computed tomography.
Int J Stroke
August 2024
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Article Synopsis
- The Alberta Stroke Program Early CT Score (ASPECTS) and penumbral imaging through computed tomography perfusion (CTP) are used to help determine who is eligible for mechanical thrombectomy (MT) in stroke patients.
- The study hypothesized that the effectiveness of recanalization in patients with large ischemic cores (volume > 50 mL) but high ASPECTS scores (≥6) would be comparable to those with smaller core volumes, and that there could be a tendency to overestimate the core size.
- Results showed that recanalization did not significantly differ between the two patient groups, and both recanalization and larger core volumes were associated with the overestimation of the ischemic core
Mechanical Thrombectomy for Acute Stroke: Early versus Late Time Window Outcomes.
J Neuroimaging
May 2020
Division of Neurology, Neuroscience Institute, Spectrum Health, Grand Rapids, MI.
Background And Purpose: Recent trials have shown benefit of thrombectomy in patients selected by penumbral imaging in the late (>6 hours) window. However, the role penumbral imaging is not clear in the early (0-6 hours) window. We sought to evaluate if time to treatment modifies the effect of endovascular reperfusion in stroke patients with evidence of salvageable tissue on CT perfusion (CTP).
View Article and Find Full Text PDFAcute imaging for evidence-based treatment of ischemic stroke.
Curr Opin Neurol
August 2019
Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Purpose Of Review: Until recently, intravenous thrombolysis and mechanical thrombectomy for acute stroke treatment relied on reported information on the known time of symptom onset and was limited to treatment within a narrow time window. New trials have provided evidence for imaging-based effective reperfusion treatment in an extended time window and unknown-onset stroke. This review summarizes evidence from recent clinical trials and suggests a simple algorithm for the choice of imaging modalities to guide evidence-based reperfusion treatment of acute stroke.
View Article and Find Full Text PDFExtending the time window for intravenous thrombolysis in acute ischemic stroke using magnetic resonance imaging-based patient selection.
Int J Stroke
July 2019
16 Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
Background: Intravenous thrombolysis with alteplase within a time window up to 4.5 h is the only approved pharmacological treatment for acute ischemic stroke. We studied whether acute ischemic stroke patients with penumbral tissue identified on magnetic resonance imaging 4.
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