https://ogma.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:52831 Wed 28 Feb 2024 16:31:25 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:53333 1 s and MTT>145%. Delay time (DT) best estimated the infarct core (AUC = 0.74). The optimal core threshold was a DT >1.5 s. The voxel-based analyses indicated CTP was most accurate in the calcarine (Penumbra-AUC = 0.75, Core-AUC = 0.79) and cerebellar regions (Penumbra-AUC = 0.65, Core-AUC = 0.79). For the volume-based analyses, MTT >160% demonstrated best correlation and smallest mean-volume difference between the penumbral estimate and follow-up MRI (R2 = 0.71). MTT >170% resulted in the smallest mean-volume difference between the core estimate and follow-up MRI, but with poor correlation (R2 = 0.11). Conclusion: CTP has promising diagnostic utility in POCI. Accuracy of CTP varies by brain region. Optimal thresholds to define penumbra were DT >1 s and MTT >145%. The optimal threshold for core was a DT >1.5 s. However, CTP core volume estimates should be interpreted with caution.]]> Wed 28 Feb 2024 16:20:57 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:51451 3 seconds on CTP. Regression analyses were used to identify clinical and imaging variables that predicted poor functional outcome. Results: A total of 139 patients with mild stroke were included, of whom 27 (19%) had poor functional outcome. Patients with poor outcome, compared with those with good outcome, had much larger perfusion lesion volume (median 80 mL vs 41 mL, p < 0.001). Perfusion lesion was a significant predictor of poor outcome in either univariable regression (crude OR = 1.02, 95% CI = [1.01-1.03]) or multivariable regression model (adjusted OR = 1.01, 95% CI = [1.01-1.02]), adjusting for occlusion site, good collaterals, baseline stroke severity, age, IV thrombolysis (IVT), and onset to scan time. A perfusion lesion of 65 mL was the optimal cutpoint to identify poor functional outcome (sensitivity = 59%, specificity = 77%). Patients with perfusion lesion ≥65 mL, compared with patients with perfusion lesion <65 mL, showed a much higher rate of poor functional outcome (38% vs 11%, p < 0.001). Of the 139 patients in this study, 95 received IVT. Patients treated with or without IVT did not influence their outcomes (crude OR = 0.74, 95% CI = [0.31-1.78]). Discussion: A perfusion lesion of ≥65 mL predicted poor functional outcome in mild stroke patients with LVO.]]> Wed 28 Feb 2024 15:56:25 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:33190 6 s region resulted in higher prognostic value than recanalization at predicting good clinical outcome (area under the curve = 0.88 and 0.74, respectively, p = 0.002). Successful reperfusion of the Tmax>6 s region (≥60%) had 89% sensitivity and 78% specificity in predicting good clinical outcome. A reperfusion index defined by Tmax>2 s or by mean transit time>145% had much lower area under the curve in comparison to Tmax>6 s measurement (p < 0.001 and p = 0.003, respectively), and had no significant difference to recanalization at predicting clinical outcome (p = 0.58 and 0.63, respectively). In conclusion, reperfusion index calculated by Tmax>6 s is a stronger predictor of clinical outcome than recanalization or other reperfusion measures.]]> Wed 23 Feb 2022 16:03:42 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:43520 Wed 21 Sep 2022 11:25:48 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:32659 Wed 19 Jan 2022 15:19:53 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:47414 Wed 18 Jan 2023 13:01:29 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:35040 Wed 17 Nov 2021 16:32:15 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:39768 Wed 13 Mar 2024 08:58:17 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:22033 Wed 11 Apr 2018 13:40:02 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44530 Wed 09 Nov 2022 10:25:52 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:33108 Wed 06 Apr 2022 14:05:06 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:33933 Wed 06 Apr 2022 14:02:47 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:29863 n = 296) who underwent 320-detector CT perfusion within 6 hours of the onset of ischemic stroke were studied. First, the ischemic volume at CT perfusion was compared with the penumbra and core reference values at magnetic resonance (MR) imaging to derive CT perfusion penumbra and core thresholds. Second, the thresholds were tested in a different group of patients to predict the final infarction at diffusion-weighted imaging 24 hours after CT perfusion. Third, the change in ischemic volume delineated by the optimal penumbra and core threshold was determined as the brain coverage was gradually reduced from 160 mm to 20 mm. The Wilcoxon signed-rank test, concordance correlation coefficient (CCC), and analysis of variance were used for the first, second, and third steps, respectively. Results: CT perfusion at penumbra and core thresholds resulted in the least volumetric difference from MR imaging reference values with delay times greater than 3 seconds and delay-corrected cerebral blood flow of less than 30% (P = .34 and .33, respectively). When the thresholds were applied to the new group of patients, prediction of the final infarction was allowed with delay times greater than 3 seconds in patients with no recanalization of the occluded artery (CCC, 0.96 [95% confidence interval: 0.92, 0.98]) and with delay-corrected cerebral blood flow less than 30% in patients with complete recanalization (CCC, 0.91 [95% confidence interval: 0.83, 0.95]). However, the ischemic volume with a delay time greater than 3 seconds was underestimated when the brain coverage was reduced to 80 mm (P = .04) and the core volume measured as cerebral blood flow less than 30% was underestimated when brain coverage was 40 mm or less (P < .0001). Conclusion: Correct threshold setting and whole-brain coverage CT perfusion allowed differentiation of the penumbra from the ischemic core in patients with acute ischemic stroke.]]> Wed 06 Apr 2022 14:00:29 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44000 Z = 2.451, P = 0.014). Conclusion: In acute LAO patients, the presence of SMCV– was a sensitive and specific imaging marker for midline shift. SMCV– had supplementary value to baseline ischemic core volume in predicting midline shift.]]> Wed 05 Oct 2022 15:04:56 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:29354 Wed 02 Mar 2022 14:26:36 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:47197 χ² analysis. Results: From 5 centers, 1,407 patients were included in this study; of these, 282 had HT. The cohort was split into a derivation cohort (1,025, 70% patients) and a validation cohort (382 patients or 30%). The extraction fraction (E) permeability map at a threshold of 30% relative to contralateral had the highest AUC at predicting any HT (derivation AUC 0.85, 95% confidence interval [CI], 0.79–0.91; validation AUC 0.84, 95% CI 0.77–0.91). The AUC improved when permeability was assessed within the acute perfusion lesion for the E maps at a threshold of 30% (derivation AUC 0.91, 95% CI 0.86–0.95; validation AUC 0.89, 95% CI 0.86–0.95). Previously proposed associations with HT and parenchymal hematoma showed lower AUC values than the permeability measure. Interpretation: In this large multicenter study, we have validated a highly accurate measure of HT prediction. This measure might be useful in clinical practice to predict hemorrhagic transformation in ischemic stroke patients before receiving alteplase alone.]]> Tue 28 Mar 2023 08:14:38 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:41993 6 s (sensitivity, 88%; specificity, 92%). The computed tomographic perfusion collateral index, defined by the ratio of delay time >6 s/delay time >2 s volume, showed a significant correlation with dynamic computed tomographic angiography collateral scores (correlation coefficient, 0.62; P<0.001), with an optimal cut point of 31.8% in predicting good collateral status (sensitivity of 83% and specificity of 86%). When predicting good clinical outcome, the delay time collateral index showed a similar predictive power to dynamic computed tomographic angiography collaterals (area under the curve, 0.78 [0.67–0.83] and 0.77 [0.69–0.84], respectively; P<0.001). Conclusions—Computed tomographic perfusion can accurately quantify collateral flow after acute ischemic stroke.]]> Tue 16 Aug 2022 16:37:23 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:49891 25 mL/h, EVT treatment (compared with IVT only) increased the odds of good clinical outcome (adjusted odds ratio=3.62 [1.21–10.76], P=0.021) and resulted in smaller final infarction volume (37.5 versus 73.9 mL, P=0.012). For patients with slow core growth of <15 mL/h, there were no significant differences between the EVT and the IVT only group in either good clinical outcome (adjusted odds ratio=1.44 [0.97–2.14], P=0.070) or final infarction volume (22.6 versus 21.9 mL, P=0.551). Conclusions: Fast core growth was associated with greater benefit from EVT compared with IVT in the early <4.5-hour time window.]]> Tue 13 Jun 2023 14:32:39 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:31178 Tue 11 Sep 2018 12:07:51 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44277 5 s (AUC: 0.80) in GM and T max > 7 s (AUC: 0.75) in WM. With sSVD, a delay time (DT) > 3 s from ddSVD was the optimal for both GM (AUC: 0.78) and WM (AUC: 0.75). Using tissue-specific thresholds for GM/WM provides more accurate estimation of acute ischemic core.]]> Tue 11 Oct 2022 14:27:33 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:28032 Tue 02 Apr 2019 10:10:23 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:23095 Thu 28 Oct 2021 12:36:41 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:33103 0.05). Despite similar baseline CTP ischemic core volumes using the previously validated measure (relative cerebral blood flow [rCBF], <30%), thrombectomy patients had a smaller median 24-hour infarct core of 17.3ml (IQR, 11.3-32.8) versus 24.3ml (IQR, 16.7-42.2; p = 0.011) in alteplase-treated controls. As a result, the optimal threshold to define the ischemic core in thrombectomy patients was rCBF <20% (area under the curve [AUC], 0.89; 95% CI, 0.84, 0.94), whereas in alteplase controls the optimal ischemic core threshold remained rCBF <30% (AUC, 0.83; 95% CI, 0.77, 0.85). Interpretation: Thrombectomy salvaged tissue with lower CBF, likely attributed to earlier reperfusion. For patients who achieve rapid reperfusion, a stricter rCBF threshold to estimate the ischemic core should be considered.]]> Thu 27 Jan 2022 15:58:26 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:36439 Thu 27 Jan 2022 15:55:31 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:42159 p = 0.0001). No association was shown between sCTA weighting, collateral grade, and clinical outcome. Conclusion: sCTA weighting did not significantly impact collateral grade using three common collateral scores or their ability to predict final infarct.]]> Thu 25 Aug 2022 16:42:47 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:42116 p < 0.001). The group with a baseline core <30 mL contained mostly patients with distal M1 or M2 occlusions, and good collaterals ( p = 0.01). In patients with a baseline ischemic core volume >30 mL (internal carotid artery and mostly proximal M1 occlusions), EVT-R increased the odds of patients achieving an excellent clinical outcome (day 90 mRS 0–1 odds ratio 1.61, p < 0.001) and there was increased symptomatic intracranial hemorrhage in the IVT-R group with core >30 mL (20% vs 3% in EVT-R, p = 0.008). Conclusion: From this observational cohort, LVO patients with larger baseline ischemic cores and proximal LVO, with poorer collaterals, clearly benefited from EVT-R compared to IVT-R alone. However, for distal LVO patients, with smaller ischemic cores and better collaterals, EVT-R was associated with a lower odds of favorable outcome compared to IVT-R alone.]]> Thu 25 Aug 2022 11:08:38 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:38979 4.5 h time window between patient groups who met and did not meet the perfusion imaging trial criteria. Methods: A discrete event simulation (DES) model was developed to simulate the long-term outcome post EVT in patients meeting or not meeting the extended time window clinical trial perfusion imaging criteria at presentation, vs. medical treatment alone (including intravenous thrombolysis). The effectiveness of thrombectomy in patients meeting the landmark trial criteria (DEFUSE 3 and DAWN) was derived from a prospective cohort study of Australian patients who received EVT for ischemic stroke, between 2015 and 2019, in the extended time window (>4.5 h). Results: Endovascular thrombectomy was shown to be a cost-effective treatment for patients satisfying the clinical trial criteria in our prospective cohort [incremental cost-effectiveness ratio (ICER) of $11,608/quality-adjusted life year (QALY) for DEFUSE 3-postive or $34,416/QALY for DAWN-positive]. However, offering EVT to patients outside of clinical trial criteria was associated with reduced benefit (−1.02 QALY for DEFUSE 3; −1.43 QALY for DAWN) and higher long-term patient costs ($8,955 for DEFUSE 3; $9,271 for DAWN), thereby making it unlikely to be cost-effective in Australia. Conclusions: Treating patients not meeting the DAWN or DEFUSE 3 clinical trial criteria in the extended time window for EVT was associated with less gain in QALYs and higher cost. Caution should be exercised when considering this procedure for patients not satisfying the trial perfusion imaging criteria for EVT.]]> Thu 24 Mar 2022 08:55:17 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:52638 Thu 19 Oct 2023 15:12:05 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:31435 P < 0.001). For every millilitre of penumbra salvaged, 7.2 days of disability-adjusted life-year days were saved (ß = -7.2, 95% confidence interval, -10.4 to -4.1 days, P < 0.001). Each minute of earlier onset-to-treatment time resulted in a saving of 4.4 disability-free days after stroke (1.3-7.5 days, P = 0.006). However, after adjustment for imaging variables, onset-to-treatment time was not significantly associated with savings in disability-adjusted life-year days. Pretreatment perfusion computed tomography can (independently of clinical variables) predict significant gains, or loss, of disability-free life in patients undergoing reperfusion therapy for stroke. The effect of earlier treatment on disability-free life appears explained by salvage of penumbra, particularly when the ischaemic core is not too large.]]> Thu 17 Feb 2022 09:30:10 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:43334 2, >4, >6, >8, and >10 s) with PH was examined using receiver operating characteristic (ROC) analysis and logistic regression. Results: Of 94 patients, 23 developed PH on follow-up imaging. Receiver operating characteristic analysis revealed that the greatest area under the curve for predicting PH occurred at DT > 4 s (area under the curve, 0.66). At this threshold of > 4 s, DT lesion volume ≥ 30.85 mL optimally predicted PH with 70% sensitivity and 59% specificity. DT > 4 s volume was independently predictive of PH in a multivariate logistic regression model (P < 0.05). Conclusions: DT > 4 s was the parameter most strongly associated with PH. The volume of moderate, not severe, hypo-perfusion on DT is more strongly associated and may allow better prediction of PH after intra-arterial tPA thrombolysis.]]> Thu 15 Sep 2022 15:04:25 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:34103 Thu 07 Feb 2019 14:26:26 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44094 3 seconds perfusion lesion with severely delayed contrast transit (delay time >3 seconds/delay time >6 seconds). Results: There were 306 patients included in this study. With every increase of 10 mmHg in baseline systolic blood pressure, the odds of achieving an excellent functional outcome decreased by 12% in multivariate analysis (odds ratio = 0.88, p = 0.048). Conversely, increased baseline blood pressure was associated with better collateral flow. In subgroup analysis of patients with major reperfusion, higher blood pressure was associated with decreased infarct growth and a better clinical outcome, and vice versa in patients without reperfusion. Interpretation: Higher baseline blood pressure in acute ischemic stroke patients with large vessel occlusion/stenosis was associated with better collateral flow. However, for patients without reperfusion, higher baseline blood pressure was associated with increased infarct growth, leading to an unfavorable clinical outcome. The relationship between blood pressure and outcomes is highly dependent on reperfusion, and active blood pressure–lowering treatment may be inappropriate in acute ischemic stroke patients prior to reperfusion treatment.]]> Thu 06 Oct 2022 16:16:26 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:47376  1.2, and mismatch volume > 10 mL on follow-up imaging. Patients were divided into PTM or non-PTM groups. Ischemic core and penumbral volumes were compared between baseline and follow-up imaging between the two groups, and collateral flow status assessed using CT perfusion collateral index. Results: A total of 25 patients (14 PTM and 11 non-PTM) were enrolled in the study. Median core volumes increased slightly in the PTM group, from 22 to 36 ml. There was a much greater increase in the non-PTM group, from 57 to 190 ml. Penumbral volumes were stable in the PTM group from a median of 79 ml at baseline to 88 ml at follow-up, whereas penumbra was reduced in the non-PTM group, from 120 to 0 ml. Collateral flow status was also better in the PTM group and the median collateral index was 33% compared with 44% in the non-PTM group (p = 0.043). Conclusion: Multiple patients were identified with limited core growth and large penumbra (persistent target mismatch) > 16 h after stroke onset, likely due to more favorable collateral flow.]]> Thu 06 Jul 2023 13:43:31 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:41242 Sat 30 Jul 2022 12:26:18 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:20613 max) was the only one with a nonsignificant difference between CTP and MRP in delineating perfusion defects. This was validated on whole-brain perfusion data, showing high concordance of T_max between the 2 modalities (concordance correlation coefficient of Lin, >0.91); the best concordance was at 6 s. At T max>6 s threshold, MRP and CTP reached substantial agreement in mismatch classification (κ >0.61). Cross-modality reperfusion calculated by T_max>6 s strongly predicted good functional outcome at 3 months (area under the curve, 0.979; P<0.05). Conclusions: MRP and CTP can be used interchangeably if one uses T_max measurement.]]> Sat 24 Mar 2018 07:55:49 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:46655 Mon 28 Nov 2022 17:43:31 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:52319 Mon 22 Apr 2024 14:04:17 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:53277 Mon 20 Nov 2023 13:02:57 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:48518 p < 0.001). Vessel occlusion location was not a strong predictor of outcomes compared to baseline ischemic core (area under the curve, mRS 0-1, 0.64 vs 0.83; mRS 0-2, 0.70 vs 0.86, p < 0.001). There was no interaction between occlusion location and ischemic core (interaction coefficient 1.00, p = 0.798). Conclusions: Ischemic stroke patients with a distal occlusion have higher rate of excellent and favorable outcome than patients with an M1 occlusion. The baseline ischemic core was shown to be a more powerful predictor of functional outcome than the occlusion location, but the relationship between ischemic core and outcome does not different by occlusion locations.]]> Mon 20 Mar 2023 17:06:46 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:48932 Mon 17 Apr 2023 15:37:11 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:41051 p < 0.001). The relationship of core growth and CTP collateral index was validated in cohort 2. An increment in collateral index by 1% resulted in an increase of core growth by 0.59 mL/h (coefficient 0.59 [0.48–0.71], p < 0.001) in cohort 2. Conclusion: Collateral status is a major determinant of ischemic core growth.]]> Mon 08 Aug 2022 14:50:17 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:46879 Mon 05 Dec 2022 14:09:44 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:51230 15 mL/h) and slow (≤15 mL/h), based on its interaction with bridging IVT in predicting the primary outcome. The primary outcome was modified Rankin scale of 0-2 at 3 months. The secondary outcomes included successful thrombectomy reperfusion defined by modified Thrombolysis in Cerebral Infarction score of 2b-3 and time from groin puncture to reperfusion. Results: Of the 1,221 EVT patients in the INSPIRE, 323 patients were selected, of which 82 patients received direct EVT and 241 patients received bridging IVT. Bridging IVT was associated with a higher rate of good clinical outcome among patients with fast core growth (39% vs 7% for direct EVT, odds ratio [OR] 8.75 [1.96-39.1], p = 0.005), but the difference was not notable for patients with slow core growth (55% vs 55% for direct EVT, OR 1.00 [0.53-1.87], p = 0.989). In patients with fast core growth, the bridging and direct EVT patients showed no difference in the reperfusion rate (80% vs 76%, p = 0.616). However, patients who received bridging IVT were more likely to achieve reperfusion earlier (the median groin to reperfusion time of 63.0 vs 94.0 minutes, p = 0.005). Discussion: Patients with fast core growth were more likely to benefit from bridging IVT. This is likely because prior IVT facilitates clot removal and thus reduces time to reperfusion.]]> Fri 25 Aug 2023 13:18:37 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:42288 Fri 19 Aug 2022 14:58:34 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:47319 70mL. We aimed to compare outcomes of EVT and non-EVT patients with an ischemic core≥70mL, hypothesizing that there would be a benefit from EVT for fair outcome (three-month modified Rankin Scale, mRS, 0-3) after stroke. METHODS: Retrospective analysis of patients enrolled into a multi-center (Australia, China and Canada) registry (2012-2020) who underwent CTP within 24 hours of stroke onset and had a baseline ischemic core≥70mL. Primary outcome was the estimation of the association of EVT in patients with core volume ≥70mL, as well as within 70-100mL and ≥100mL subgroups with fair outcome. RESULTS: Of the 3283 patients in the registry, 299 had CTP core≥70 mL and 269 complete data (135 had core volume between 70-100mL and 134≥100mL). EVT was performed in 121(45%) patients. EVT-treated patients were younger (median 69 versus 75 years; p=0.011), had lower pre-stroke mRS, and smaller median core volumes, 92[79-116.5]mL versus 105.5[85.75-138]mL, (p=0.004). EVT-treated patients had higher odds of achieving fair outcome in adjusted analysis (30% versus 13.9% in the non-EVT group; aOR 2.1(95% CI 1, 4.2), p=0.038). The benefit was seen predominantly in those with 70-100mL core (71 /135 (52.6%) EVT-treated), with 54.3% in EVT-treated versus 21% in non-EVT group achieving a fair outcome (aOR 2.5 (95% CI 1, 6.2), p=0.005). Of those with a core≥100mL, 50 /134(37.3%) underwent EVT. Proportions of fair outcome were very low in both groups (8.1% versus 8.7%; p=0.908). DISCUSSION: We found a positive association of EVT with 3-month outcome after stroke in patients with a baseline CTP ischemic core volume 70-100 mL but not in those with ≥100 mL. Randomized data to confirm these findings is required. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that EVT is associated with better motor outcomes 3 months following CTP-defined ischemic stroke with core of 70-100 mL.]]> Fri 13 Jan 2023 11:06:45 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:41588 Fri 05 Aug 2022 14:52:10 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:41585 Fri 05 Aug 2022 14:51:26 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:30100 p = 0.022) and did not have different rates of mRS 0 to 2 (72% treated patients vs 77% untreated; RR, 0.93; 95% CI, 0.82-1.95; p = 0.23). Interpretation: This large observational cohort suggests that a portion of ischemic stroke patients clinically eligible for alteplase therapy with a small perfusion lesion have a good natural history and may not benefit from treatment.]]> Fri 01 Apr 2022 09:25:36 AEDT ]]>