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Updated: May 6, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Patient selection for mechanical thrombectomy.

M Nelles¹, S Greschus, M Möhlenbruch

¹Department of Radiology, University of Bonn Medical Center, Sigmund Freud Str. 25, 53105, Bonn, Germany, michael.nelles@ukb.uni-bonn.de.

Clinical Neuroradiology

|October 18, 2013

Summary

This summary is machine-generated.

In mechanical thrombectomy for stroke, smaller infarct core size and a lower ratio of core to tissue at risk significantly predict favorable clinical outcomes, outperforming time-based factors.

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Area of Science:

Neurology
Radiology
Interventional Cardiology

Background:

Acute ischemic stroke necessitates timely reperfusion therapies.
Mechanical thrombectomy is a key treatment for large vessel occlusions.
Predicting clinical outcomes after thrombectomy is crucial for patient management.

Purpose of the Study:

To assess the impact of multimodal CT-derived tissue parameters on clinical outcomes after mechanical thrombectomy.
To compare the predictive value of tissue parameters versus procedural time metrics for stroke recovery.

Main Methods:

Retrospective analysis of 301 acute ischemic stroke patients, with 65 undergoing mechanical thrombectomy.
Utilized unenhanced CT and perfusion CT (PCT) to quantify infarct core and tissue at risk.
Evaluated procedural parameters including time from symptom onset to recanalization.

Main Results:

Successful recanalization (TICI 2b/3) achieved in 89% of patients.
Infarct core size and its ratio to tissue at risk were significant predictors of clinical outcome (p=0.007 and p=0.001, respectively).
Smaller infarct cores and lower core-to-risk ratios correlated with better outcomes.

Conclusions:

Infarct core size and the core-to-tissue at risk ratio are more critical determinants of clinical outcome than time-related factors in mechanical thrombectomy.
Perfusion CT parameters offer valuable insights into predicting functional recovery post-thrombectomy.