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PT  - JOURNAL ARTICLE
AU  - Mujanovic, Adnan
AU  - Kurmann, Christoph C.
AU  - Manhart, Michael
AU  - Piechowiak, Eike I.
AU  - Pilgram-Pastor, Sara M.
AU  - Serrallach, Bettina L.
AU  - Boulouis, Gregoire
AU  - Meinel, Thomas R.
AU  - Seiffge, David J.
AU  - Jung, Simon
AU  - Arnold, Marcel
AU  - Nguyen, Thanh N.
AU  - Fischer, Urs
AU  - Gralla, Jan
AU  - Dobrocky, Tomas
AU  - Mordasini, Pasquale
AU  - Kaesmacher, Johannes
TI  - Value of Immediate Flat Panel Perfusion Imaging after Endovascular Therapy (AFTERMATH): A Proof of Concept Study
AID  - 10.3174/ajnr.A8103
DP  - 2024 Feb 01
TA  - American Journal of Neuroradiology
PG  - 163--170
VI  - 45
IP  - 2
4099  - http://www.ajnr.org/content/45/2/163.short
4100  - http://www.ajnr.org/content/45/2/163.full
SO  - Am. J. Neuroradiol.2024 Feb 01; 45
AB  - BACKGROUND AND PURPOSE: Potential utility of flat panel CT perfusion imaging (FPCT-PI) performed immediately after mechanical thrombectomy (MT) is unknown. We aimed to assess whether FPCT-PI obtained directly post-MT could provide additional potentially relevant information on tissue reperfusion status.MATERIALS AND METHODS: This was a single-center analysis of all patients with consecutive acute stroke admitted between June 2019 and March 2021 who underwent MT and postinterventional FPCT-PI (n = 26). A core lab blinded to technical details and clinical data performed TICI grading on postinterventional DSA images and qualitatively assessed reperfusion on time-sensitive FPCT-PI maps. According to agreement between DSA and FPCT-PI, all patients were classified into 4 groups: hypoperfusion findings perfectly matched by location (group 1), hypoperfusion findings mismatched by location (group 2), complete reperfusion on DSA with hypoperfusion on FPCT-PI (group 3), and hypoperfusion on DSA with complete reperfusion on FPCT-PI (group 4).RESULTS: Detection of hypoperfusion (present/absent) concurred in 21/26 patients. Of these, reperfusion findings showed perfect agreement on location and size in 16 patients (group 1), while in 5 patients there was a mismatch by location (group 2). Of the remaining 5 patients with disagreement regarding the presence or absence of hypoperfusion, 3 were classified into group 3 and 2 into group 4. FPCT-PI findings could have avoided TICI overestimation in all false-positive operator-rated TICI 3 cases (10/26).CONCLUSIONS: FPCT-PI may provide additional clinically relevant information in a considerable proportion of patients undergoing MT. Hence, FPCT-PI may complement the evaluation of reperfusion efficacy and potentially inform decision-making in the angiography suite.AISacute ischemic strokeeTICIexpanded Thrombolysis in Cerebral InfarctionFPCT-PIflat panel CT perfusion imagingMTmechanical thrombectomyTmaxtime to maximum