Computed Tomography Angiography (CTA) identify which stroke patients would most benefit from a procedure to restore blood flow, potentially saving thousands of lives a year.
In the study published in the journal Radiology, researchers examined the results from 31 patients with large-vessel occlusions (LVOs) who had undergone CTA on admission to hospital.
The patients then had MRI scans over the next two days to track how much the LVO was growing.
The researchers found a ‘strong’ link between ischemic core growth and collateral vessels triggered during blood flow loss.
Nearly half of the patients showed very low core growth, representing a significant number of patients who would benefit from thrombectomy 24 hours or more after suffering an ischemic stroke.
The researchers, led by Dr Robert Regenhardt, PhD, wrote: “Ischemic core volume is one of the strongest determinants of 90-day outcomes, even among patients who undergo EVT [thrombectomy].
“In our study, worse collaterals were an independent determinant of larger ischemic core volume at presentation, even when controlling for other variables including occlusion site, NIHSS [NIH stroke scale] score and age.”
Thrombectomy is more than 90 per cent effective if clinicians reach the patient in time, said study co-first author R. Gilberto Gonzalez M.D., Ph.D., from the Department of Radiology at Massachusetts General Hospital (MGH) in Boston.
However, at the moment, doctors are treating less than 10 per cent of those who could benefit.
But because CTA is widely available, the technology could offer a potential lifeline to thousands of stroke victims who live in areas where MRI machines are not available.
The researchers are now working to develop an AI algorithm that can automatically detect patterns associated with slower stroke progression.
Hospitals can share this information in the cloud, getting an evaluation within minutes.
“This method is very amenable to automation,” Dr Gonzalez said. “This is how I see it having a major effect and benefitting tens of thousands of people every year.”
