Prognostic Predictive Value of Infarct Growth Rate in Acute Cerebral Infarction with Large Vessel Occlusion

Area of Science:

• Neurology
• Radiology
• Cardiovascular Research

Background:

• Acute ischemic stroke (AIS) poses a significant health challenge.
• Endovascular thrombectomy (EVT) is a critical treatment for AIS.
• Predicting patient prognosis post-EVT is crucial for effective management.

Purpose of the Study:

• To evaluate the predictive value of infarct growth rate (IGR) using CT perfusion (CTP) imaging.
• To determine if IGR can forecast poor prognosis in AIS patients undergoing EVT.
• To assess the combined predictive power of IGR and NIHSS score.

Main Methods:

• Analysis of a prospective clinical database of AIS patients undergoing EVT.
• Calculation of IGR as ischemic core volume divided by time from stroke onset to imaging.
• Multivariate logistic regression, restricted cubic spline, and ROC curve analyses were used.

Main Results:

• A total of 232 patients were analyzed; 35.8% had a poor prognosis.
• Elevated IGR was an independent predictor of poor prognosis (aOR: 1.17; P<0.001).
• The combination of NIHSS score and IGR showed strong predictive performance (AUC: 0.90).

Conclusions:

• Elevated infarct growth rate (IGR) is an independent predictor of poor prognosis in AIS patients post-EVT.
• IGR derived from CTP imaging offers valuable prognostic information.
• IGR may assist clinicians in stratifying risk and tailoring treatment strategies.