Flat panel imaging of occlusion site and collateral scores for emergent large vessel occlusion

Lucas Elijovich, Asim Choudhri, David Martineau, Joe Sullivan, Violiza Inoa Acosta, Christopher Nickele, Daniel Hoit, Adam Arthur, Julie DiNitto

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Flat panel imaging for emergent large vessel occlusion can be acquired prior to mechanical thrombectomy (MT). In this study, we examined patients undergoing MT with computed tomography angiography (CTA) to determine agreement on the site of occlusion and CTA collateral score (CS). Methods: Flat Panel CTA (FP-CTA) was acquired before MT. Time between CTA and FP-CTA acquisition, site of occlusion, and CS were reported. Significant CS change was defined as >2-point change, or any change to/from a malignant profile (CS = 0 to CS > 0, or vice versa). Results: Eleven patients (mean age, 60.8 years; NIHSS, 17; 55.0% female) were included; IV tPA was administered to 7. Intra-reader occlusion site, dichotomous CS, and continuous CS correlation between CTA and FP-CTA were 96.6%, 90.0%, and 86.6%, respectively. Inter-reader correlation for occlusion site was 93% for CTA and 100% for FP-CTA; dichotomous CS correlation was 87% for both CTA and FP-CTA; correlation of continuous CS was 77% for CTA and 87% for FP-CTA. Conclusion: Standard CTA and FP-CTA have high intra and inter-reader correlation determining site of occlusion and CS in ELVO setting. This angiographic tool may have potential applications for both triage and patient selection.

Original languageEnglish (US)
Pages (from-to)12-16
Number of pages5
JournalJournal of the Neurological Sciences
Volume401
DOIs
StatePublished - Jun 15 2019

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Thrombectomy
Computed Tomography Angiography
Triage
Patient Selection

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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Flat panel imaging of occlusion site and collateral scores for emergent large vessel occlusion. / Elijovich, Lucas; Choudhri, Asim; Martineau, David; Sullivan, Joe; Acosta, Violiza Inoa; Nickele, Christopher; Hoit, Daniel; Arthur, Adam; DiNitto, Julie.

In: Journal of the Neurological Sciences, Vol. 401, 15.06.2019, p. 12-16.

Research output: Contribution to journalArticle

Elijovich, Lucas ; Choudhri, Asim ; Martineau, David ; Sullivan, Joe ; Acosta, Violiza Inoa ; Nickele, Christopher ; Hoit, Daniel ; Arthur, Adam ; DiNitto, Julie. / Flat panel imaging of occlusion site and collateral scores for emergent large vessel occlusion. In: Journal of the Neurological Sciences. 2019 ; Vol. 401. pp. 12-16.
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abstract = "Introduction: Flat panel imaging for emergent large vessel occlusion can be acquired prior to mechanical thrombectomy (MT). In this study, we examined patients undergoing MT with computed tomography angiography (CTA) to determine agreement on the site of occlusion and CTA collateral score (CS). Methods: Flat Panel CTA (FP-CTA) was acquired before MT. Time between CTA and FP-CTA acquisition, site of occlusion, and CS were reported. Significant CS change was defined as >2-point change, or any change to/from a malignant profile (CS = 0 to CS > 0, or vice versa). Results: Eleven patients (mean age, 60.8 years; NIHSS, 17; 55.0{\%} female) were included; IV tPA was administered to 7. Intra-reader occlusion site, dichotomous CS, and continuous CS correlation between CTA and FP-CTA were 96.6{\%}, 90.0{\%}, and 86.6{\%}, respectively. Inter-reader correlation for occlusion site was 93{\%} for CTA and 100{\%} for FP-CTA; dichotomous CS correlation was 87{\%} for both CTA and FP-CTA; correlation of continuous CS was 77{\%} for CTA and 87{\%} for FP-CTA. Conclusion: Standard CTA and FP-CTA have high intra and inter-reader correlation determining site of occlusion and CS in ELVO setting. This angiographic tool may have potential applications for both triage and patient selection.",
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AU - Choudhri, Asim

AU - Martineau, David

AU - Sullivan, Joe

AU - Acosta, Violiza Inoa

AU - Nickele, Christopher

AU - Hoit, Daniel

AU - Arthur, Adam

AU - DiNitto, Julie

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N2 - Introduction: Flat panel imaging for emergent large vessel occlusion can be acquired prior to mechanical thrombectomy (MT). In this study, we examined patients undergoing MT with computed tomography angiography (CTA) to determine agreement on the site of occlusion and CTA collateral score (CS). Methods: Flat Panel CTA (FP-CTA) was acquired before MT. Time between CTA and FP-CTA acquisition, site of occlusion, and CS were reported. Significant CS change was defined as >2-point change, or any change to/from a malignant profile (CS = 0 to CS > 0, or vice versa). Results: Eleven patients (mean age, 60.8 years; NIHSS, 17; 55.0% female) were included; IV tPA was administered to 7. Intra-reader occlusion site, dichotomous CS, and continuous CS correlation between CTA and FP-CTA were 96.6%, 90.0%, and 86.6%, respectively. Inter-reader correlation for occlusion site was 93% for CTA and 100% for FP-CTA; dichotomous CS correlation was 87% for both CTA and FP-CTA; correlation of continuous CS was 77% for CTA and 87% for FP-CTA. Conclusion: Standard CTA and FP-CTA have high intra and inter-reader correlation determining site of occlusion and CS in ELVO setting. This angiographic tool may have potential applications for both triage and patient selection.

AB - Introduction: Flat panel imaging for emergent large vessel occlusion can be acquired prior to mechanical thrombectomy (MT). In this study, we examined patients undergoing MT with computed tomography angiography (CTA) to determine agreement on the site of occlusion and CTA collateral score (CS). Methods: Flat Panel CTA (FP-CTA) was acquired before MT. Time between CTA and FP-CTA acquisition, site of occlusion, and CS were reported. Significant CS change was defined as >2-point change, or any change to/from a malignant profile (CS = 0 to CS > 0, or vice versa). Results: Eleven patients (mean age, 60.8 years; NIHSS, 17; 55.0% female) were included; IV tPA was administered to 7. Intra-reader occlusion site, dichotomous CS, and continuous CS correlation between CTA and FP-CTA were 96.6%, 90.0%, and 86.6%, respectively. Inter-reader correlation for occlusion site was 93% for CTA and 100% for FP-CTA; dichotomous CS correlation was 87% for both CTA and FP-CTA; correlation of continuous CS was 77% for CTA and 87% for FP-CTA. Conclusion: Standard CTA and FP-CTA have high intra and inter-reader correlation determining site of occlusion and CS in ELVO setting. This angiographic tool may have potential applications for both triage and patient selection.

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