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Erschienen in:
05.12.2023 | Original Article
Predicting 3-month Functional Outcome After Endovascular Thrombectomy in Patients with Anterior Circulation Occlusion with an Arterial Transit Artifact Grading System
Erschienen in: Clinical Neuroradiology | Ausgabe 1/2024
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Purpose
The objective of this study was to evaluate the relationship between arterial transit artifact (ATA), arterial spin labeling (ASL) perfusion imaging, and the outcome of patients with acute ischemic stroke (AIS) due to occlusion of large vessels in anterior circulation after endovascular thrombectomy (EVT).
Methods
Patients with anterior circulation occlusion treated with EVT between October 2017 and December 2021 were enrolled in this retrospective study, and ATA was quantified by a 4-point scale. A favorable outcome was defined by modified Rankin Scale (mRS) scores of 0–2 at 3 months. To identify independent predictors of favorable outcome, age, sex, risk factors, baseline National Institutes of Health Stroke Scale (NIHSS) score, site of occlusion, cause of stroke, and early reperfusion were evaluated with univariate and multivariate analyses. Predictive accuracy was evaluated by calculating the area under the receiver operating characteristic (ROC) curve (AUC) for the model.
Results
In this study 187 patients (age, 65.0 ± 12.5 years; men, 55%) were evaluated. Younger age (odds ratio, OR, 0.95; 95% confidence interval, CI, 0.92–0.98, p = 0.002), lower baseline NIHSS score (OR, 0.88; 95% CI, 0.82–0.94, p < 0.001), and lower ATA score (OR, 1.14; 95% CI, 1.06–1.22, p < 0.001) were independently associated with favorable outcomes in multivariate analysis. The ATA score has moderate to good accuracy in predicting favorable outcomes (AUC, 0.753).
Conclusion
A high ATA score as a potential predictor, can help identify patients who may benefit from EVT.