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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleAdult Brain
Open Access

One-Stop Management with Perfusion for Transfer Patients with Stroke due to a Large-Vessel Occlusion: Feasibility and Effects on In-Hospital Times

A. Brehm, I. Tsogkas, I.L. Maier, H.J. Eisenberger, P. Yang, J.-M. Liu, J. Liman and M.-N. Psychogios
American Journal of Neuroradiology August 2019, 40 (8) 1330-1334; DOI: https://doi.org/10.3174/ajnr.A6129
A. Brehm
aFrom the Departments of Neuroradiology (A.B., I.T., H.J.E., M.-N.P.)
dDepartment of Neuroradiology (A.B., I.T., M.-N.P.), Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
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I. Tsogkas
aFrom the Departments of Neuroradiology (A.B., I.T., H.J.E., M.-N.P.)
dDepartment of Neuroradiology (A.B., I.T., M.-N.P.), Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
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I.L. Maier
bNeurology (I.L.M., H.J.E., J.L.), University Medical Center Goettingen, Goettingen, Germany
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H.J. Eisenberger
aFrom the Departments of Neuroradiology (A.B., I.T., H.J.E., M.-N.P.)
bNeurology (I.L.M., H.J.E., J.L.), University Medical Center Goettingen, Goettingen, Germany
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P. Yang
cDepartment of Neurosurgery (P.Y., J.-M.L.), Changhai Hospital, Second Military Medical University, Changhai, China
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J.-M. Liu
cDepartment of Neurosurgery (P.Y., J.-M.L.), Changhai Hospital, Second Military Medical University, Changhai, China
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J. Liman
bNeurology (I.L.M., H.J.E., J.L.), University Medical Center Goettingen, Goettingen, Germany
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M.-N. Psychogios
aFrom the Departments of Neuroradiology (A.B., I.T., H.J.E., M.-N.P.)
dDepartment of Neuroradiology (A.B., I.T., M.-N.P.), Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
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  • Article
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    Fig 1.

    FPDCT angiography for the identification of an LVO on a transversal FPDCT angiogram (A), a coronal FPDCT angiogram (B), and early-phase (C) and late-phase (D) collaterals.

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    Fig 2.

    Reconstruction of the CBV (A), CBF (B), and MTT (C) map by the syngo X Workplace (Siemens). Visualization of the 10-mL infarct core (D), the 225-mL mismatch volume (E) by the RAPID ANGIO software solution, and the final infarction on a follow-up CT scan 2 days after the thrombectomy (F).

Tables

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    Table 1:

    Baseline characteristics and time metrics of the patients with one-stop and MDCT perfusiona

    One-Stop Perfusion (n = 15)MDCT Perfusion (n = 23)P Value
    Baseline characteristics
        Female (No.)791
        Age (yr)78 (68–88)68 (61–78).048b
        NIHSS_a15 (12–19)18 (14–24).117
        CCT-ASPECTS8 (8–9)7 (6–9).149
        Symptom to door241 (204–282)248 (175–327).784
        Other CT to in-house CT133 (114–156)170 (145–327).06
    Time metrics
        Door to CT11 (8–25)15 (11–25).129
        Door to groin24 (19–34)53 (41–69)<.001b
        In-house CT to groin14 (10–22)34 (22–43)<.001b
        Door to reperfusion76 (59–95)97 (81–122).078
        Groin to reperfusion41 (33–76)54 (29–68).578
        In-house CT to reperfusion55 (47–85)80 (63–106).083
    Safety parameters
        sICH1 (6.7%)2 (8.7%)1
        Mortality4 (26.7%)4 (17.4%).114
        SAH on follow-up scan1 (6.7%)3 (13%)1
    • Note:—CCT indicates cranial CT; NIHSS_a, admission NIHSS; Other CT to in-house CT, external CT to our CT; sICH, symptomatic intracranial hemorrhage.

    • ↵a Data are median and IQR or No. (%).

    • ↵b Significant.

    • View popup
    Table 2:

    Subjective evaluation of the quality of the FPDCT angiography and perfusion

    VariableNo Diagnostic Quality/SeverePoor Diagnostic Quality/SubstantialFair Diagnostic Quality/TolerableGood Diagnostic Quality/NegligiblePerfect Diagnostic Quality/None
    FPDCT angiography/perfusion overall01374
    Detection of LVO00357
    Evaluation of collaterals00456
    FPDCT perfusion11364
    Motion artifacts12453
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American Journal of Neuroradiology: 40 (8)
American Journal of Neuroradiology
Vol. 40, Issue 8
1 Aug 2019
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One-Stop Management with Perfusion for Transfer Patients with Stroke due to a Large-Vessel Occlusion: Feasibility and Effects on In-Hospital Times
A. Brehm, I. Tsogkas, I.L. Maier, H.J. Eisenberger, P. Yang, J.-M. Liu, J. Liman, M.-N. Psychogios
American Journal of Neuroradiology Aug 2019, 40 (8) 1330-1334; DOI: 10.3174/ajnr.A6129
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  • Derivation and validation of a predictive scale to expedite endovascular intervention for acute stroke patients with an intervenable vessel occlusion
  • Cost-utility of direct transfer to angiography suite (DTAS) bypassing conventional imaging for patients with acute ischemic stroke in Spain: results from the ANGIOCAT trial
  • Direct to angiosuite strategy versus standard workflow triage for endovascular therapy: systematic review and meta-analysis
  • Clinical Applications of Conebeam CTP Imaging in Cerebral Disease: A Systematic Review
  • Dual-Layer Detector Cone-Beam CT Angiography for Stroke Assessment: First-in-Human Results (the Next Generation X-ray Imaging System Trial)
  • Cost-utility of direct transfer to angiography suite (DTAS) bypassing conventional imaging for patients with acute ischemic stroke in Spain: results from the ANGIOCAT trial
  • Dual-Layer Detector Cone-Beam CT Angiography for Stroke Assessment: First-in-Human Results (the Next Generation X-ray Imaging System Trial)
  • Dual-Layer Detector Cone-Beam CT Angiography for Stroke Assessment: First-in-Human Results (the Next Generation X-ray Imaging System Trial)
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Cite this article
A. Brehm, I. Tsogkas, I.L. Maier, H.J. Eisenberger, P. Yang, J.-M. Liu, J. Liman, M.-N. Psychogios
One-Stop Management with Perfusion for Transfer Patients with Stroke due to a Large-Vessel Occlusion: Feasibility and Effects on In-Hospital Times
American Journal of Neuroradiology Aug 2019, 40 (8) 1330-1334; DOI: 10.3174/ajnr.A6129

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