Factors affecting pre‑ and post‑stenting computed tomography perfusion in patients with middle cerebral artery stenosis

Qu,Hui; Li,Jinli; Zhao,Xingquan; Dong,Kehui

doi:10.3892/etm.2012.805

Factors affecting pre‑ and post‑stenting computed tomography perfusion in patients with middle cerebral artery stenosis

Authors:
- Hui Qu
- Jinli Li
- Xingquan Zhao
- Kehui Dong
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Affiliations: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing 100050, P.R. China
Published online on: November 9, 2012 https://doi.org/10.3892/etm.2012.805
Pages: 471-474

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Abstract

The aim of this study was to investigate the factors affecting pre‑ and post‑stenting head computed tomography perfusion (CTP) in patients with middle cerebral artery stenosis. A total of 25 patients with severe middle cerebral artery stenosis were enrolled. CTP was performed prior to and following stenting. Scores were allocated to the time‑to‑peak (TTP) parameter of CTP using the Alberta stroke program early computed tomography scoring (ASPECTS) scale. The factors possibly affecting pre‑ and post‑stenting CTP were analyzed. All the patients exhibited markedly prolonged TTP on the affected side prior to stenting, compared with the healthy side. Following surgery, the TTP was improved in all patients. The preoperative ASPECTS score was negatively correlated with the degree of middle cerebral artery stenosis with a correlation coefficient of ‑5.78. The preoperative vascular stenosis rate was positively correlated with the improvement degree of the ASPECTS score with a correlation coefficient of 1.137 (P=0.001). TTP is a sensitive parameter for evaluating the effect of stenting on middle cerebral artery stenosis. TTP prior to and following stenting may be quantitatively assessed using the ASPECTS scale. Patients with serious stenosis and/or good collateral circulation are able to benefit more from stenting.

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1.	Gasparotti R, Grassi M, Mardighian D, et al: Perfusion CT in patients with acute ischemic stroke treated with intra-arterial thrombolysis: predictive value of infarct core size on clinical outcome. AJNR. 30:722–727. 2009. View Article : Google Scholar : PubMed/NCBI
2.	d’Esterre CD, Aviv RI and Lee TY: The evolution of the cerebral blood volume abnormality in patients with ischemic stroke: a CT perfusion study. Acta Radiol. 53:461–467. 2012.PubMed/NCBI
3.	König M: Brain perfusion CT in acute stroke: current status. Eur J Radiol. 45(Suppl 1): S11–S22. 2003.
4.	Galvez M, York GE 2nd and Eastwood JD: CT perfusion parameter values in regions of diffusion abnormalities. AJNR Am J Neuroradiol. 25:1205–1210. 2004.PubMed/NCBI
5.	Smith WS, Roberts HC, Chuang NA, et al: Safety and feasibility of a CT protocol for acute stroke: combined CT, CT angiography, and CT perfusion imaging in 53 consecutive patients. AJNR Am J Neuroradiol. 24:688–690. 2003.PubMed/NCBI
6.	Jiang WJ, Wang YJ, Du B, et al: Stenting of symptomatic M1 stenosis of middle cerebral artery: an initial experience of 40 patients. Stroke. 35:1375–1380. 2004. View Article : Google Scholar : PubMed/NCBI
7.	Chimowitz MI, Lynn MJ, Derdeyn CP, et al: Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med. 365:993–1003. 2011. View Article : Google Scholar
8.	Gröschel K, Schnaudigel S, Pilgram SM, Wasser K and Kastrup A: A systematic review on outcome after stenting for intracranial atherosclerosis. Stroke. 40:e340–e347. 2009.PubMed/NCBI
9.	SSYLVIA Study Investigators: Stenting of Symptomatic Atherosclerotic Lesions in the Vertebral or Intracranial Arteries (SSYLVIA): study results. Stroke. 35:1388–1392. 2004. View Article : Google Scholar : PubMed/NCBI
10.	Suh DC, Kim JK, Choi JW, et al: Intracranial stenting of severe symptomatic intracranial stenosis: results of 100 consecutive patients. AJNR Am J Neuroradiol. 29:781–785. 2008. View Article : Google Scholar : PubMed/NCBI
11.	Roberts HC, Dillon WP and Smith WS: Dynamic CT perfusion to assess the effect of carotid revascularization in chronic cerebral ischemia. AJNR Am J Neuroradiol. 21:421–425. 2000.PubMed/NCBI
12.	Trojanowska A, Drop A, Jargiello T, Wojczal J and Szczerbo-Trojanowska M: Changes in cerebral hemodynamics after carotid stenting: evaluation with CT perfusion studies. J Neuroradiol. 33:169–174. 2006. View Article : Google Scholar : PubMed/NCBI
13.	Barber PA, Demchuk AM, Zhang J and Buchan AM: Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group Alberta Stroke Programme Early CT Score. Lancet. 355:1670–1674. 2000. View Article : Google Scholar
14.	Pexman JH, Barber PA, Hill MD, et al: Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 22:1534–1542. 2001.PubMed/NCBI
15.	Mori T, Fukuoka M, Kazita K and Mori K: Follow-up study after intracranial percutaneous transluminal cerebral balloon angioplasty. AJNR Am J Neuroradiol. 19:1525–1533. 1998.PubMed/NCBI
16.	Feldman RL, Trigg L, Gaudier J and Galat J: Use of coronary Palmaz-Schatz stent in the percutaneous treatment of an intracranial carotid artery stenosis. Cathet Cardiovasc Diagn. 38:316–319. 1996. View Article : Google Scholar : PubMed/NCBI
17.	Higashida RT, Furlan AJ, Roberts H, et al: Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke. Stroke. 34:e109–e137. 2003. View Article : Google Scholar : PubMed/NCBI
18.	Kalia J, Wolfe T and Zaidat OO: Limb-shaking transient ischemic attack masquerading as lumbar radiculopathy from pericallosal artery stenosis treated successfully with intracranial angioplasty and stenting. J Stroke Cerebrovasc Dis. 19:169–173. 2010. View Article : Google Scholar