Abstract WMP69: Association Between Computed Tomography Perfusion Parameters and Functional Independence in Acute Ischemic Stroke Post-Endovascular Therapy: A Secondary Analysis from the SELECT Study

• DOI: 10.1161/str.56.suppl_1.wmp69
• Publication Date: 2025-01-30T10:15:32Z
• Authors: Adeeb Narangoli; Bassam Yaghmoor; Deep Pujara; Faisal Alshaibi; Yazid Saidi; Ameena Shafiq; Mohammed Albedaiwi; Alhassin Al Mosta...; Sophia Sundararajan; Cathy Sila; Amanda Opaskar; Wei Xiong; Michael DeGeorgia; Kelsey Duncan; Abhishek Ray; Yin Hu; Jeffrey Sunshine; Nicholas Bambakidis; Amrou Sarraj
• Keywords: Stroke; Acute stroke

Introduction: Cerebral computed tomography perfusion (CTP) imaging has been well-established for identifying candidates endovascular therapy (EVT) in acute ischemic stroke. This study investigates the association between CTP parameters and functional independence post-EVT using data from SELECT study. Methods: We analyzed baseline images patients, focusing on those with available cerebral blood volume (CBV), flow (CBF), time to maximum (Tmax) maps. Patients who received EVT medical management only (MM) were included. Logistic regression models created age, national institutes of health stroke scale (NIHSS), arrival, occlusion location, transfer status, CT ASPECTS as covariates, at 90 days (modified Rankin score 0-2) outcome. Receiver operating characteristic (ROC) curves generated, area under curve (AUC) values calculated compared DeLong’s test. Results: Among 361 171 (139 EVT, 32 MM) had volumetric estimates pre-defined thresholds. Median (IQR) age NIHSS 68 (56-78) 16 (12-20), 48% females. Estimates different thresholds within a given parameter showed high correlation (>0.8), moderate (>0.4-0.6) was observed across (all p<0.05, figure 1). ROC revealed AUC >0.7 all both (figure 2) combined (EVT + MM, 3) subgroups, highest CBF thresholds: <30% [EVT – 0.7507, 0.8028], <34% 0.737, 0.7857] <38% - 0.7351, 0.7831], followed by CBV then Tmax parameters. No significant differences found (EVT: p=0.88; combined: p=0.46). Conclusion: All demonstrated (>0.7) particularly <30%, indicating their potential prognostic markers.