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Delayed CTP-Derived Deep Venous Outflow: A Novel Predictor of Striatocapsular Infarction after M1 Thrombectomy

S Peretz1,2, K Pardo1,2, J Naftali1,2

  • 1From the Departments of Neurology (S.P., K.P., J.N., M.F., G.R., R.B., E.A.).

AJNR. American Journal of Neuroradiology
|October 20, 2022
PubMed

Insights

Delayed venous outflow, measured by thalamostriate time to peak (TTP) difference on CT perfusion, predicts striatocapsular infarction after M1 thrombectomy. This finding aids in assessing stroke risk in these patients.

Area of Science:

  • Neurology
  • Radiology
  • Stroke Medicine

Background:

  • Striatocapsular infarction is a common complication following M1 segment thrombectomy for ischemic stroke.
  • Assessing deep venous outflow parameters at presentation is crucial for predicting this complication.

Purpose of the Study:

  • To investigate the correlation between CTP-derived deep venous outflow parameters and subsequent striatocapsular infarction.
  • To evaluate thalamostriate time to peak difference (ΔTTP) as a predictor of striatocapsular injury.

Main Methods:

  • Retrospective analysis of 116 patients undergoing M1 thrombectomy.
  • CT perfusion (CTP) was used to measure time to peak (TTP) and enhancement in deep cerebral veins.
  • Striatocapsular infarction was assessed on NCCT 24 hours post-procedure.

Main Results:

  • Sixty-one patients (52.6%) developed striatocapsular infarction.
  • A significantly higher mean thalamostriate ΔTTP was observed in patients with striatocapsular infarction (1.95s vs 0.79s, P=.010).
  • Thalamostriate ΔTTP showed a positive correlation with the severity of striatocapsular injury (P=.030).

Conclusions:

  • CTP-derived thalamostriate ΔTTP is a reliable surrogate marker for predicting striatocapsular infarction post-M1 thrombectomy.
  • Measuring venous outflow parameters from CTP offers potential for improved stroke outcome prediction.
Abstract

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