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Updated: May 6, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Computed tomography perfusion deficit volume predicts the functional outcome of endovascular therapy for basilar
Yiying Pan1, Pengjun Chen1, Shunyang Chen1
1Zhejiang Provincial Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University, Lishui, 323000, PR China.
Insights
Computed tomography perfusion deficit volumes predict functional outcomes in basilar artery occlusion (BAO) patients after endovascular therapy. Larger deficits correlate with poorer outcomes, aiding risk assessment.
Area of Science:
- Neuroimaging
- Neurology
- Interventional Radiology
Background:
- Basilar artery occlusion (BAO) is a severe condition with high rates of disability and mortality.
- Endovascular therapy has emerged as a crucial treatment for BAO.
- Predicting functional outcomes is essential for guiding treatment decisions and patient management.
Purpose of the Study:
- To evaluate the association between baseline computed tomography (CT) perfusion deficit volumes and functional outcomes in BAO patients.
- To identify CT perfusion parameters that can predict good functional outcomes after endovascular therapy.
Main Methods:
- Retrospective analysis of 64 BAO patients who underwent endovascular therapy.
- Multi-modal CT on admission, including perfusion imaging.
- Assessment of ischemic changes using the posterior-circulation Acute Stroke Prognosis Early CT Score.
- Quantification of perfusion deficit volumes using Syngo.via software.
- Primary outcome: good functional outcome defined as modified Rankin Scale score ≤ 3 at 90 days.
- Logistic regression and ROC curve analysis to identify predictors.
Main Results:
- 26 (41%) patients achieved good functional outcomes; 38 (59%) had poor outcomes.
- Tmax > 10s, Tmax > 6s, and reduced cerebral blood flow (rCBF) < 30% volumes were independent predictors of good functional outcomes.
- Receiver operating characteristic (ROC) curve analysis showed strong prognostic value (AUCs: 0.85, 0.81, 0.78).
Conclusions:
- CT perfusion deficit volumes are valuable for predicting functional outcomes in BAO patients post-endovascular treatment.
- These imaging metrics help identify patients at high risk of disability and mortality.
- CT perfusion imaging can aid in optimizing treatment strategies for BAO.
Objectives:
To investigate the relationship between baseline computed tomography perfusion deficit volumes and functional outcomes in patients with basilar artery occlusion (BAO) undergoing endovascular therapy.
Methods:
This was a single-center study in which the data of 64 patients with BAO who underwent endovascular therapy were retrospectively analyzed. All the patients underwent multi-model computed tomography on admission. The posterior-circulation Acute Stroke Prognosis Early Computed Tomography Score was applied to assess the ischemic changes. Perfusion deficit volumes were obtained using Syngo.via software. The primary outcome of the analysis was a good functional outcome (90-day modified Rankin Scale score ≤ 3). Logistic regression and receiver operating characteristic curves were used to explore predictors of functional outcome.
Results:
A total of 64 patients (median age, 68 years; 72 % male) were recruited, of whom 26 (41 %) patients achieved good functional outcomes, while 38 (59 %) had poor functional outcomes. Tmax > 10 s, Tmax > 6 s, and rCBF < 30 % volume were independent predictors of good functional outcomes (odds ratio range, 1.0-1.2; 95 % confidence interval [CI], 1.0-1.4]) and performed well in the receiver operating characteristic curve analyses, exhibiting positive prognostic value; the areas under the curve values were 0.85 (95 % CI, 0.75-0.94), 0.81 (95 % CI, 0.70-0.90), and 0.78 (95 % CI, 0.67-0.89).
Conclusion:
Computed tomography perfusion deficit volume represents a valuable tool in predicting high risk of disability and mortality in patients with BAO after endovascular treatment.
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