Related Experiment Video
Updated: Aug 6, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Noncontrast CT Versus CT Perfusion for Predicting Functional Outcomes After Endovascular Therapy in Acute Anterior
Gaoshan Zhao1, Wei Guo2, Xiangjun Xu1
1Department of Neurology, Yijishan Hospital, Wannan Medical University, Wuhu, Anhui, China (G.Z., Y.G., H.C., S.C., J.X., K.Y., X.F., P.Z., X.H., Z.Z.).
Rationale And Objectives:
This study aimed to investigate the impact of different imaging screening paradigms on outcomes in patients with large vessel occlusion (LVO) stroke who underwent endovascular therapy (EVT) in real-world settings.
Materials And Methods:
In this retrospective study, patients were categorised into two groups according to preprocedural imaging: Basic Imaging Group (Noncontrast computed tomography ± computed tomographic angiography) and Advanced Imaging Group (computed tomography perfusion). A favourable outcome was defined as a modified Rankin scale score between 0-2 at 90 days. Multivariable logistic regression was used to assess the impact of imaging paradigms on outcomes and to examine the heterogeneity of this effect across different treatment windows (0-6 vs. 6-24 h).
Results:
Despite longer workflow times with computed tomography perfusion, no significant differences were found in 90-day mortality (19.86% vs. 15.84%, P=0.143), symptomatic intracranial haemorrhage (6.53% vs. 6.98%, P=0.801), or favourable outcomes (mRS 0-2: 49.75% vs. 48.51%, P=0.728) among the 892 patients included. Multivariate analyses confirmed that imaging modality was not an independent predictor of unfavourable functional outcomes (aOR=0.86; 95% CI 0.62-1.21), mortality (aOR=0.96; 95% CI 0.59-1.55), or haemorrhage transformation (aOR=0.82; 95% CI 0.46-1.47).
Conclusion:
In this real-world study, the imaging modality used for patient selection was not associated with 90-day outcomes after EVT. These findings support the safety and efficacy of a simplified noncontrast computed tomography-based paradigm for selecting anterior circulation LVO stroke patients for thrombectomy across all time windows.
