Evidence map›Paper›PMID 34649382›Full record

ArticleJournal of stroke2021

Impact of Multiphase Computed Tomography Angiography for Endovascular Treatment Decision-Making on Outcomes in Patients with Acute Ischemic Stroke.

Johanna M Ospel, Ondrej Volny, Wu Qiu, Mohamed Najm, Moiz Hafeez, Sarah Abdalrahman, Enrico Fainardi, Marta Rubiera, Alexander Khaw, Jai J Shankar and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Multi-phase CT-Angiography outperforms angiographic careggi collateral score and predicts functional outcome in acute ischemic stroke.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Johanna M OspelDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Ondrej VolnyCzech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Wu QiuDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Mohamed NajmDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Moiz HafeezDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Sarah AbdalrahmanDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Enrico FainardiDepartment of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
Marta RubieraDepartment of Neurology, Hospital Vall d´Hebron, Barcelona, Spain.
Alexander KhawDepartment of Clinical Neurosciences, London Health Sciences Centre, University of Western Ontario, London, ON, Canada.
Jai J ShankarDepartment of Radiology, University of Manitoba, Winnipeg, MB, Canada.
Michael D HillDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Mohammed A AlmekhlafiDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Andrew M DemchukDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Mayank GoyalDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Bijoy K MenonDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.

Funding

Canadian Institute of Health Research
6 · The paper itself

Abstract

background and purposeVarious imaging paradigms are used for endovascular treatment (EVT) decision-making and outcome estimation in acute ischemic stroke (AIS). We aim to compare how these imaging paradigms perform for EVT patient selection and outcome estimation.

methodsProspective multi-center cohort study of patients with AIS symptoms with multi-phase computed tomography angiography (mCTA) and computed tomography perfusion (CTP) baseline imaging. mCTA-based EVT-eligibility was defined as presence of large vessel occlusion (LVO) and moderate-to-good collaterals on mCTA. CTP-based eligibility was defined as presence of LVO, ischemic core (defined on relative cerebral blood flow, absolute cerebral blood flow, and cerebral blood volume maps) <70 mL, mismatch-ratio >1.8, absolute mismatch >15 mL. EVT-eligibility and adjusted rates of good outcome (modified Rankin Scale 0-2) based on these imaging paradigms were compared.

resultsOf 289/464 patients with LVO, 263 (91%) were EVT-eligible by mCTA-criteria versus 63 (22%), 19 (7%) and 103 (36%) by rCBF, aCBF, and CBV-CTP-criteria. CTP and mCTA-criteria were discordant in 40% to 53%. Estimated outcomes were best in patients who met both mCTA and CTP eligibility-criteria and were treated with EVT (62% to 87% good outcome). Patients eligible for EVT by mCTA-criteria and not by CTP-criteria receiving EVT achieved good outcome rates of 53% to 57%. Few patients met CTP-criteria and not mCTA-criteria for EVT.

conclusionsSimpler imaging selection criteria that rely on little else than detection of the occluded blood vessel may be more sensitive and less specific, thus resulting in more patients being offered EVT and arguably benefiting from it.

Indexed as

Cerebrovascular circulationIschemiaIschemic stroke

Identifiers

PMID34649382
PMCPMC8521256

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.