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Updated: Dec 12, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Computed tomography perfusion in patients of stroke with left ventricular assist device
Kazufumi Suzuki1, Tomohiro Nishinaka2, Minori Tateishi2
1Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. kasuzuki-rad@umin.ac.jp.
Insights
Computed tomographic perfusion (CTP) effectively diagnoses acute ischemic stroke (AIS) in patients with left ventricular assist devices (LVAD). This imaging technique aids in identifying candidates for endovascular thrombectomy (EVT), improving patient outcomes.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Left ventricular assist devices (LVADs) are crucial for heart failure management.
- LVAD recipients face an elevated risk of cerebral thrombosis.
- Early diagnosis of acute ischemic stroke (AIS) is vital in these patients.
Purpose of the Study:
- To evaluate the utility of computed tomographic perfusion (CTP) for diagnosing AIS in LVAD patients.
- To assess CTP's role in identifying candidates for endovascular thrombectomy (EVT).
Main Methods:
- Retrospective analysis of 33 contrast-enhanced CTP scans from 12 LVAD patients with suspected AIS.
- Scans were performed between January 2017 and December 2018.
- Patients had no definitive ischemic findings or hemorrhage on non-contrast CT.
Main Results:
- CTP diagnosed AIS with perfusion deficits in 33.3% of scans (4/12 patients).
- Endovascular thrombectomy (EVT) was successfully performed in 3 patients (4 procedures).
- CTP accurately guided EVT decisions without serious complications.
Conclusions:
- CTP is a valuable tool for early AIS diagnosis in LVAD patients.
- CTP can identify patients with a recoverable ischemic penumbra eligible for EVT.
- CTP may become the primary assessment for AIS in LVAD recipients.
Abstract:
Left ventricular assist devices (LVAD) are widely applied for patients with severe heart failure as a bridge to heart transplantation as well as destination therapy. Patients with implanted LVAD have an increased risk of cerebral thrombosis and computed tomographic perfusion (CTP) has the potential to be performed for early diagnosis and treatment of acute ischemic stroke (AIS), including interventional thrombectomy. Here, we report our series of CTP examination in patients having suspected AIS after LVAD implantation. We retrospectively investigated 33 contrast-enhanced CTPs from January 2017 to December 2018 which were performed in 12 cases of patients because of possible neurological findings leading to suspected AIS during LVAD circulatory support who did not have definite ischemic findings nor intracerebral hemorrhage on non-contrast computed tomography. AIS with perfusion disturbance area was diagnosed in 11 (33.3%) out of a total of 33 CTPs in 4 (33.3%) out of 12 patients. Endovascular thrombectomy (EVT) was successfully performed in this research study four times for three patients. CTP was able to detect and determine the indication for EVT without serious complications. CTP could potentially be the first-choice assessment for early diagnosis of AIS with recoverable ischemic penumbra in patients with LVAD implantation.
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