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<meta name="DC.Title" content="Prediction of Stent-Retriever Thrombectomy Outcomes by Dynamic Multidetector CT Angiography in Patients with Acute Carotid T or MCA Occlusions" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4694" />
<meta name="DC.Date" content="2016-07-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2016 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The selection of patients for endovascular therapy is an important issue in stroke imaging. The aim of this study was to determine the predictive value of 3 different dynamic CT angiography parameters, occlusion length, collateralization extent, and time delay to maximum enhancement, for latest generation of stent retriever thrombectomy recanalization outcomes in patients with acute ischemic stroke.

MATERIALS AND METHODS: In this study, subjects were selected from an initial cohort of 2059 consecutive patients who had undergone multiparametric CT, including whole-brain CT perfusion. We included all patients with a complete occlusion of the M1 segment of the MCA or the carotid T and subsequent intra-arterial stent retriever thrombectomy. Dynamic CT angiography was reconstructed from whole-brain CT perfusion raw datasets. Angiographic outcome was scored by using the modified TICI scale; and clinical outcome, by using the modified Rankin Scale. Logistic regression analyses were performed to determine independent predictors of a favorable angiographic (mTICI = 3) and clinical outcome (mRS ≤2).

RESULTS: Sixty-nine patients (mean age, 68 ± 14 years; 46% men) were included for statistical analysis. In the regression analysis, a short occlusion length was an independent predictor of favorable angiographic outcome (OR, 0.41; P &lt; .05). Both collateralization grade (OR, 1.00; P &gt; .05) and time delay to peak enhancement (OR, 0.90; P &gt; .05) failed to predict a favorable angiographic outcome. None of the dynamic CT angiography predictors were significantly associated with clinical outcome on discharge (OR, 0.664–1.011; P = .330–.953) or at 90 days (OR, 0.779–1.016; P = .130–.845).

CONCLUSIONS: A short occlusion length as determined by dynamic CT angiography is an independent predictor of a favorable angiographic outcome of stent retriever thrombectomy in patients with ischemic stroke.

IVT
:   intravenous thrombolysis
mTICI
:   modified Thrombolysis in Cerebral Infarction scale
spCTA
:   single-phase CT angiography
WB-CTP
:   whole-brain CT perfusion" />
<meta name="DC.Contributor" content="K.M. Thierfelder" />
<meta name="DC.Contributor" content="W.H. Sommer" />
<meta name="DC.Contributor" content="B. Ertl-Wagner" />
<meta name="DC.Contributor" content="S.E. Beyer" />
<meta name="DC.Contributor" content="F.G. Meinel" />
<meta name="DC.Contributor" content="W.G. Kunz" />
<meta name="DC.Contributor" content="G. Buchholz" />
<meta name="DC.Contributor" content="M.F. Reiser" />
<meta name="DC.Contributor" content="H. Janssen" />
<meta name="article:published_time" content="2016-07-01" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="Prediction of Stent-Retriever Thrombectomy Outcomes by Dynamic Multidetector CT Angiography in Patients with Acute Carotid T or MCA Occlusions" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The selection of patients for endovascular therapy is an important issue in stroke imaging. The aim of this study was to determine the predictive value of 3 different dynamic CT angiography parameters, occlusion length, collateralization extent, and time delay to maximum enhancement, for latest generation of stent retriever thrombectomy recanalization outcomes in patients with acute ischemic stroke.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;In this study, subjects were selected from an initial cohort of 2059 consecutive patients who had undergone multiparametric CT, including whole-brain CT perfusion. We included all patients with a complete occlusion of the M1 segment of the MCA or the carotid T and subsequent intra-arterial stent retriever thrombectomy. Dynamic CT angiography was reconstructed from whole-brain CT perfusion raw datasets. Angiographic outcome was scored by using the modified TICI scale; and clinical outcome, by using the modified Rankin Scale. Logistic regression analyses were performed to determine independent predictors of a favorable angiographic (mTICI = 3) and clinical outcome (mRS ≤2).&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Sixty-nine patients (mean age, 68 ± 14 years; 46% men) were included for statistical analysis. In the regression analysis, a short occlusion length was an independent predictor of favorable angiographic outcome (OR, 0.41; &lt;i&gt;P&lt;/i&gt; &amp;lt; .05). Both collateralization grade (OR, 1.00; &lt;i&gt;P&lt;/i&gt; &amp;gt; .05) and time delay to peak enhancement (OR, 0.90; &lt;i&gt;P&lt;/i&gt; &amp;gt; .05) failed to predict a favorable angiographic outcome. None of the dynamic CT angiography predictors were significantly associated with clinical outcome on discharge (OR, 0.664–1.011; &lt;i&gt;P&lt;/i&gt; = .330–.953) or at 90 days (OR, 0.779–1.016; &lt;i&gt;P&lt;/i&gt; = .130–.845).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;A short occlusion length as determined by dynamic CT angiography is an independent predictor of a favorable angiographic outcome of stent retriever thrombectomy in patients with ischemic stroke.&lt;/p&gt;" />
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<meta name="twitter:title" content="Prediction of Stent-Retriever Thrombectomy Outcomes by Dynamic Multidetector CT Angiography in Patients with Acute Carotid T or MCA Occlusions" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The selection of patients for endovascular therapy is an important issue in stroke imaging. The aim of this study was to determine the predictive value of 3 different dynamic CT angiography parameters, occlusion length, collateralization extent, and time delay to maximum enhancement, for latest generation of stent retriever thrombectomy recanalization outcomes in patients with acute ischemic stroke.

MATERIALS AND METHODS: In this study, subjects were selected from an initial cohort of 2059 consecutive patients who had undergone multiparametric CT, including whole-brain CT perfusion. We included all patients with a complete occlusion of the M1 segment of the MCA or the carotid T and subsequent intra-arterial stent retriever thrombectomy. Dynamic CT angiography was reconstructed from whole-brain CT perfusion raw datasets. Angiographic outcome was scored by using the modified TICI scale; and clinical outcome, by using the modified Rankin Scale. Logistic regression analyses were performed to determine independent predictors of a favorable angiographic (mTICI = 3) and clinical outcome (mRS ≤2).

RESULTS: Sixty-nine patients (mean age, 68 ± 14 years; 46% men) were included for statistical analysis. In the regression analysis, a short occlusion length was an independent predictor of favorable angiographic outcome (OR, 0.41; P &lt; .05). Both collateralization grade (OR, 1.00; P &gt; .05) and time delay to peak enhancement (OR, 0.90; P &gt; .05) failed to predict a favorable angiographic outcome. None of the dynamic CT angiography predictors were significantly associated with clinical outcome on discharge (OR, 0.664–1.011; P = .330–.953) or at 90 days (OR, 0.779–1.016; P = .130–.845).

CONCLUSIONS: A short occlusion length as determined by dynamic CT angiography is an independent predictor of a favorable angiographic outcome of stent retriever thrombectomy in patients with ischemic stroke.

IVT
:   intravenous thrombolysis
mTICI
:   modified Thrombolysis in Cerebral Infarction scale
spCTA
:   single-phase CT angiography
WB-CTP
:   whole-brain CT perfusion" />
<meta name="og-title" property="og:title" content="Prediction of Stent-Retriever Thrombectomy Outcomes by Dynamic Multidetector CT Angiography in Patients with Acute Carotid T or MCA Occlusions" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/37/7/1296" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The selection of patients for endovascular therapy is an important issue in stroke imaging. The aim of this study was to determine the predictive value of 3 different dynamic CT angiography parameters, occlusion length, collateralization extent, and time delay to maximum enhancement, for latest generation of stent retriever thrombectomy recanalization outcomes in patients with acute ischemic stroke.

MATERIALS AND METHODS: In this study, subjects were selected from an initial cohort of 2059 consecutive patients who had undergone multiparametric CT, including whole-brain CT perfusion. We included all patients with a complete occlusion of the M1 segment of the MCA or the carotid T and subsequent intra-arterial stent retriever thrombectomy. Dynamic CT angiography was reconstructed from whole-brain CT perfusion raw datasets. Angiographic outcome was scored by using the modified TICI scale; and clinical outcome, by using the modified Rankin Scale. Logistic regression analyses were performed to determine independent predictors of a favorable angiographic (mTICI = 3) and clinical outcome (mRS ≤2).

RESULTS: Sixty-nine patients (mean age, 68 ± 14 years; 46% men) were included for statistical analysis. In the regression analysis, a short occlusion length was an independent predictor of favorable angiographic outcome (OR, 0.41; P &lt; .05). Both collateralization grade (OR, 1.00; P &gt; .05) and time delay to peak enhancement (OR, 0.90; P &gt; .05) failed to predict a favorable angiographic outcome. None of the dynamic CT angiography predictors were significantly associated with clinical outcome on discharge (OR, 0.664–1.011; P = .330–.953) or at 90 days (OR, 0.779–1.016; P = .130–.845).

CONCLUSIONS: A short occlusion length as determined by dynamic CT angiography is an independent predictor of a favorable angiographic outcome of stent retriever thrombectomy in patients with ischemic stroke.

IVT
:   intravenous thrombolysis
mTICI
:   modified Thrombolysis in Cerebral Infarction scale
spCTA
:   single-phase CT angiography
WB-CTP
:   whole-brain CT perfusion" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14448--5" data-node-nid="14448" id="top-node-14448--6940372523" data-pisa="ajnr;37/7/1296" data-pisa-master="ajnr;ajnr.A4694" data-apath="/ajnr/37/7/1296.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">INTERVENTIONAL</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Prediction of Stent-Retriever Thrombectomy Outcomes by Dynamic Multidetector CT Angiography in Patients with Acute Carotid T or MCA Occlusions</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">K.M. Thierfelder</span>, <span class="highwire-citation-author" data-delta="1">W.H. Sommer</span>, <span class="highwire-citation-author" data-delta="2">B. Ertl-Wagner</span>, <span class="highwire-citation-author" data-delta="3">S.E. Beyer</span>, <span class="highwire-citation-author" data-delta="4">F.G. Meinel</span>, <span class="highwire-citation-author" data-delta="5">W.G. Kunz</span>, <span class="highwire-citation-author" data-delta="6">G. Buchholz</span>, <span class="highwire-citation-author" data-delta="7">M.F. Reiser</span> and <span class="highwire-citation-author" data-delta="8">H. Janssen</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">July 2016,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1296-1302; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4694 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14448--6940372523" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">K.M. Thierfelder </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.M.%2BThierfelder%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Thierfelder%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AK.M.%2BThierfelder%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4557-6295" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K.M. Thierfelder</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">W.H. Sommer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.H.%2BSommer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sommer%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AW.H.%2BSommer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-8504-5141" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for W.H. Sommer</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">B. Ertl-Wagner </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.%2BErtl-Wagner%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ertl-Wagner%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.%2BErtl-Wagner%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-1120-2471" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B. Ertl-Wagner</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">S.E. Beyer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.E.%2BBeyer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Beyer%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.E.%2BBeyer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-2859-9276" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.E. Beyer</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">F.G. Meinel </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.G.%2BMeinel%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Meinel%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.G.%2BMeinel%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3201-1033" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F.G. Meinel</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">W.G. Kunz </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.G.%2BKunz%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kunz%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AW.G.%2BKunz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-5021-1952" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for W.G. Kunz</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">G. Buchholz </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurology (G.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.%2BBuchholz%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Buchholz%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.%2BBuchholz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3704-0925" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G. Buchholz</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">M.F. Reiser </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.F.%2BReiser%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Reiser%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.F.%2BReiser%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-1098-8190" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.F. Reiser</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">H. Janssen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Neuroradiology (H.J.), Ludwig-Maximilian University Hospital, Munich, Germany.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BJanssen%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Janssen%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.%2BJanssen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5903-1280" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> The selection of patients for endovascular therapy is an important issue in stroke imaging. The aim of this study was to determine the predictive value of 3 different dynamic CT angiography parameters, occlusion length, collateralization extent, and time delay to maximum enhancement, for latest generation of stent retriever thrombectomy recanalization outcomes in patients with acute ischemic stroke.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>MATERIALS AND METHODS:</strong> In this study, subjects were selected from an initial cohort of 2059 consecutive patients who had undergone multiparametric CT, including whole-brain CT perfusion. We included all patients with a complete occlusion of the M1 segment of the MCA or the carotid T and subsequent intra-arterial stent retriever thrombectomy. Dynamic CT angiography was reconstructed from whole-brain CT perfusion raw datasets. Angiographic outcome was scored by using the modified TICI scale; and clinical outcome, by using the modified Rankin Scale. Logistic regression analyses were performed to determine independent predictors of a favorable angiographic (mTICI = 3) and clinical outcome (mRS ≤2).</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>RESULTS:</strong> Sixty-nine patients (mean age, 68 ± 14 years; 46% men) were included for statistical analysis. In the regression analysis, a short occlusion length was an independent predictor of favorable angiographic outcome (OR, 0.41; <em>P</em> &lt; .05). Both collateralization grade (OR, 1.00; <em>P</em> &gt; .05) and time delay to peak enhancement (OR, 0.90; <em>P</em> &gt; .05) failed to predict a favorable angiographic outcome. None of the dynamic CT angiography predictors were significantly associated with clinical outcome on discharge (OR, 0.664–1.011; <em>P</em> = .330–.953) or at 90 days (OR, 0.779–1.016; <em>P</em> = .130–.845).</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>CONCLUSIONS:</strong> A short occlusion length as determined by dynamic CT angiography is an independent predictor of a favorable angiographic outcome of stent retriever thrombectomy in patients with ischemic stroke.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">IVT<span class="def-item-dt-sep"></span></dt><dd>intravenous thrombolysis<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">mTICI<span class="def-item-dt-sep"></span></dt><dd>modified Thrombolysis in Cerebral Infarction scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">spCTA<span class="def-item-dt-sep"></span></dt><dd>single-phase CT angiography<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">WB-CTP<span class="def-item-dt-sep"></span></dt><dd>whole-brain CT perfusion</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2016 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/37/7/1296.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 37</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 7 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jul 2016 </div></div>
      
      
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      <div class="highwire-cite-title">Prediction of Stent-Retriever Thrombectomy Outcomes by Dynamic Multidetector CT Angiography in Patients with Acute Carotid T or MCA Occlusions</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">K.M.</span> <span class="nlm-surname">Thierfelder</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">W.H.</span> <span class="nlm-surname">Sommer</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Ertl-Wagner</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.E.</span> <span class="nlm-surname">Beyer</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">F.G.</span> <span class="nlm-surname">Meinel</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">W.G.</span> <span class="nlm-surname">Kunz</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Buchholz</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">M.F.</span> <span class="nlm-surname">Reiser</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Janssen</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jul 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1296-1302; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4694 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">K.M.</span> <span class="nlm-surname">Thierfelder</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">W.H.</span> <span class="nlm-surname">Sommer</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Ertl-Wagner</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.E.</span> <span class="nlm-surname">Beyer</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">F.G.</span> <span class="nlm-surname">Meinel</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">W.G.</span> <span class="nlm-surname">Kunz</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Buchholz</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">M.F.</span> <span class="nlm-surname">Reiser</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Janssen</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jul 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1296-1302; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4694 </span></div>
  
  
  
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