CT Perfusion Imaging After Selection for Late-Window Endovascular Stroke Treatment

作者：Susanne G. H. Olthuis, Florentina M.E. Pinckaers, M M Q Robbe, Inger R. de Ridder, Jan W. Hoving, Esmée Venema, Jasper D. Daems, F.A.V. Pirson, Julie Staals, Bart J. Emmer, Hester F. Lingsma, Stefan D. Roosendaal, Anouk van der Hoorn, Miou S. Koopman, Alida A. Postma, Diederik W.J. Dippel, Charles B.L.M. Majoie, Robert J. van Oostenbrugge, Wim H. van Zwam, van Robert J. Oostenbrugge, Wim H van Zwam, Susanne G. H. Olthuis, Florentina M.E. Pinckaers, de Inger R. Ridder, F.A.V. Pirson, M M Q Robbe, Jan W. Hoving, Hester F. Lingsma, Julie Staals, Bart J. Emmer, Stefan D. Roosendaal, van der Anouk Hoorn, Alida A. Postma, Diederik W.J. Dippel, Charles B.L.M. Majoie, van der Aad Lugt, van Adriaan C. G. M. Es, Bob Roozenbeek, van Pieter-Jan Doornmaal, Yvo B.W.E.M. Roos, Jonathan M. Coutinho, van der Bart Worp, Rob Lo, van Marianne A. A. Walderveen, Marieke J.H. Wermer, van Ewoud I. Dijk, Sjoerd F.M. Jenniskens, Hieronymus D. Boogaarts, Maarten Uyttenboogaart, Reinoud P.H. Bokkers, Koos Keizer, Rob A.R. Gons, Lonneke S.F. Yo, den Heleen M. Hertog, Van Hasselt, Wouter J. Schonewile, Jan Albert Vos, van Julia H. Tuijl, Issam Boukrab, Hans Kortman, Jeannette Hofmaijer, Jasper M. Martens, van den Ido R. Wijngaard, Jelis Boiten, Geert J. Lycklama à Nijeholt, Paul J.A.M. Brouwers, Emiel J.C. Sturm, Tomas Bulut, de Karlijn F. Laat, van Lukas C. Dijk, Michel Remmers, De Jong, Anouk D. Rozeman, Otto E. H. Elgersma, van der Bas Veen, Davy R. Sudiono, Heinrich P. Mattle, Jens Fiehler, Sander M. J. van Kuijk, Daan Nieboer, van Rick Nuland, G. M. Krietemeijer, van den René Berg, Ludo F.M. Beenen, Sebastiaan Hammer, Anton Meijer, van der Anouk D. Hoorn, Albert J. Yoo, Dick Gerrits, Ben P. W. Jansen, Martine T.B. Truijman, Sanne Manschot, Henk Kerkhoff, Peter J. Koudstaal, Vicky Chalos, Olvert A. Berkhemer, Andriaan Versteeg, Lennard Wolff, Jiahang Su, van der P. M. (Matthijs) Sluijs, van Henk Voorst, Manon L. Tolhuisen, ten Hugo Cate, de Maat, Samantha Donse-Donkel, Heleen M.M. van Beusekom, Aladdin Taha, Aarazo Barakzie, Wouter H. Hinsenveld, Robert‐Jan B. Goldhoorn, Kilian M. Treurniet, van den Sophie Berg, Natalie E. LeCouffe, van de Rob Graaf, Angelique Ceulemans, Robrecht R. M. M. Knapen, L. Sontag, Rik Reinink, Suzanne M. Silvis, Floris H.B.M. Schreuder, Simone Uniken Venema, van Laura C. C. Meenen, Sabine Collete, van Wijngaarden, Virginia Steen, Sabrina Verheesen, Martin Sterrenberg, El Naziha Ghannouti, Rita Sprengers, van Ayla Ahee, Berber Zweedijk, Wilma Pellikaan, Irati Schonewile, Kitty Blauwendraat, Yvonne Drabbe, Anke Kleine-Kathöfer, de Joke Meris, Michelle Sandiman, Tamara Dofferhoff-Vermeulen, Michelle Simons, Hester Bongenaar, Maylee Smallegange, Van Loon, Karin Kraus, Erna Bos-Verheij, Esther Santegoets, Suze Kooij, Annemarie Slotboom, Eva Ponjee, Rieke Eilander, Hanneke Droste, van Esther Veen, Rosalie Visser, Jasmijn Lodico, de Marieke Jong, van der Friedus Minne, Eefje Cleophas, Ernst B. Muskens, Amy Nijst, Leontien Heiligers, Yvonne Märtens, Miranda Slotboom, Rogier Hintzen, Bart C. Jacobs · 发表于：JAMA Neurology · 年份：2025 · DOI：10.1001/jamaneurol.2025.0716 · 被引用次数：17 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Cerebrovascular and Carotid Artery Diseases

Importance: MR CLEAN-LATE (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands for Late Arrivals) showed efficacy of endovascular treatment (EVT) in the late window (6-24 hours after stroke symptom onset or time last seen well) among patients with ischemic stroke selected based on collateral flow. Therefore, the future role of computed tomography perfusion (CTP) imaging in patient selection for late-window EVT may change. Objective: To investigate the interaction among CTP parameters (core volumes, penumbra volumes, and mismatch ratio) and the association of EVT with functional outcomes among patients in the late window after ischemic stroke selected based on collateral flow. Design, Setting, and Participants: This is a post hoc secondary analysis of MR CLEAN-LATE, a multicenter randomized clinical trial, with open-label treatment and blinded end point, conducted from February 2, 2018, to January 27, 2022, in 18 Dutch stroke intervention centers. Participants included 502 patients with anterior circulation large vessel occlusion and present collateral flow on results of computed tomographic angiography in the late window after stroke, who gave deferred consent and were included in MR CLEAN-LATE. All patients had completed follow-up at 90 days. This secondary analysis included 313 patients (62%) with available CTP results. Statistical analysis was performed in September 2023. Intervention: Patients were randomized to rece...