CTP-guided reperfusion therapy in acute ischemic stroke: a meta-analysis

Acta Neurol Scand. 2021 Apr;143(4):355-366. doi: 10.1111/ane.13374. Epub 2020 Nov 27.

Abstract

Background: Computed tomography perfusion (CTP) imaging could be useful in guiding reperfusion therapy or patient selection in acute ischemic stroke (AIS) patients. The aim of the current study was to determine the efficacy of the CTP-guided reperfusion therapy in AIS by performing a systematic review and meta-analysis.

Methods: Medline/PubMed, Embase, and the Cochrane library were searched using the terms: "CT perfusion", "acute stroke" and "reperfusion therapy". The following studies were included: (a) studies reporting original data; (b) patients aged 18 years or above; (c) patients diagnosed with anterior circulation AIS; and (d) studies with good methodological design.

Results: Twenty-two studies were finally included in the metanalysis with a total of 5, 687 patients. CTP-guided reperfusion therapy was associated with increased odds of good functional outcome without significant difference in safety profile.

Conclusions: CTP-guided reperfusion therapy improved functional outcomes in AIS, with increased benefits to patients treated with endovascular thrombectomy.

Keywords: CT perfusion; decision-making; ischemic stroke; patient selection; treatment.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Aged
  • Brain Ischemia / diagnostic imaging*
  • Brain Ischemia / therapy*
  • Female
  • Humans
  • Ischemic Stroke / diagnostic imaging*
  • Ischemic Stroke / therapy*
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic / methods
  • Reperfusion / methods*
  • Thrombectomy / methods
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome