AUTHOR=Gao Jiali , Jing Zhen , Huang Shengming , Yang Jiajie , Guan Min , Zhang Shijun , Li Hao , Li Yongxin , Lu Kui , Yang Ming , Huang Li’an 

TITLE=Comparison of clinical outcomes in patients with acute ischemic stroke who underwent endovascular treatment using different perfusion modalities: a real-world multicenter study

JOURNAL=Frontiers in Neurology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1275715

DOI=10.3389/fneur.2023.1275715

ISSN=1664-2295

ABSTRACT=<sec id="sec1"><title>Background</title><p>Advanced perfusion modalities are increasingly popular for various diseases. However, few studies have focused on contrasting perfusion patterns.</p></sec><sec id="sec2"><title>Objective</title><p>This study aimed to compare the time efficiency and clinical outcomes of patients with acute ischemic stroke (AIS) who underwent endovascular treatment (EVT) before one-stop arterial spin labeling (ASL) and computed tomography perfusion (CTP) protocols.</p></sec><sec id="sec3"><title>Methods</title><p>This study retrospectively included 326 patients with AIS who had accepted EVT within 24 h of onset from four comprehensive stroke centers between October 2017 and September 2022. After 1:1 matching of the propensity scores, 202 patients were separated into two groups: the ASL group (<italic>n</italic> = 101) and the CTP group (<italic>n</italic> = 101).</p></sec><sec id="sec4"><title>Results</title><p>Functional independence at 90 days (modified Rankin Scale [mRS] 0–2; <italic>p</italic> = 0.574), onset-to-puncture time (<italic>p</italic> = 0.231), door-to-puncture time (<italic>p</italic> = 0.136), and door-to-perfusion time (<italic>p</italic> = 0.646) were not significantly different between the two groups. The proportion of EVT complications (31.7% in the ASL group vs. 14.9% in the CTP group, <italic>p</italic> = 0.005) and symptomatic intracranial hemorrhage (sICH) at 24 h (23.8% in the ASL group vs. 9.9% in the CTP group, <italic>p</italic> = 0.008) in the CTP group were lower than the ASL group. The ischemic core volume was a common predictor of favorable outcomes in both ASL (<italic>p</italic> &lt; 0.001) and CTP (p &lt; 0.001) groups.</p></sec><sec id="sec5"><title>Conclusion</title><p>There were no significant differences in time efficiency and efficacy outcomes between the two groups of patients receiving one-stop ASL and CTP. The proportion of sICH at 24 h and EVT complications of patients in the CTP group was lower than the ASL group. The ischemic core volume was an independent predictor for favorable outcomes.</p></sec>