ArticleJournal of neuroendovascular therapy2026
Impact of RAPID-Based Patient Selection on Endovascular Therapy Outcomes in Acute Ischemic Stroke: A Retrospective Comparative Study.
Article in Journal of neuroendovascular therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Perfusion imaging is widely used in acute ischemic stroke to guide endovascular thrombectomy (EVT). This study evaluated clinical outcomes among patients selected for EVT using perfusion software-based analysis compared with those selected without it. Methods: We conducted a retrospective comparative analysis of patients with large- or medium-vessel occlusion who underwent EVT between 2024 and 2025. Patients were categorized into a perfusion software group (RAPID implementation period) and a non-perfusion software group (non-RAPID period) based on the use of RAPID imaging software (iSchemaView, Menlo Park, CA, USA). The primary outcome was the proportion of patients achieving a good clinical outcome at 90 days, defined as a modified Rankin Scale (mRS) score of 0-3. Secondary outcomes included a shift analysis of mRS scores, procedural time metrics, all hemorrhagic events including symptomatic intracerebral hemorrhage (sICH), and 90-day mortality. Results: A total of 54 patients were included (RAPID implementation period, 26; non-RAPID period, 28). At 90 days, the proportion of patients achieving a good outcome (mRS 0-3) was similar between the RAPID implementation period group and the non-RAPID period group (50.0% vs. 46.4%; P = 0.72). In the ordinal shift analysis of mRS scores, there was no significant difference in the overall distribution between groups (common odds ratio, 0.91; 90% confidence interval [CI], 0.41-1.99; P = 0.84). The median time from hospital arrival to groin puncture was also similar-45 min (interquartile range [IQR], 40-58) versus 46 min (IQR, 39-63; P = 0.96). The incidences of any intracerebral hemorrhage (30.8% vs. 32.1%), sICH (0% vs. 3.6%), and 90-day mortality (15.0% vs. 7.1%) were likewise comparable between the RAPID and non-RAPID periods. Conclusion: These findings suggest that automated, perfusion-based patient selection enhances workflow standardization and can be seamlessly integrated into acute stroke management to optimize both speed and safety.
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