- Title
- Ischemic Lesion Growth in Patients with a Persistent Target Mismatch After Large Vessel Occlusion
- Creator
- Tomari, Shinya; Lillicrap, Thomas; Garcia-Esperon, Carlos; Kashida, Yumi Tomari; Bivard, Andrew; Lin, Longting; Levi, Christopher R.; Spratt, Neil J.
- Relation
- Clinical Neuroradiology Vol. -, Issue 5 July 2022
- Publisher Link
- http://dx.doi.org/10.1007/s00062-022-01180-z
- Publisher
- Springer
- Resource Type
- journal article
- Date
- 2022
- Description
- Background: Failure to reperfuse a cerebral occlusion resulting in a persistent penumbral pattern has not been fully described. Methods: We retrospectively reviewed patients with anterior large vessel occlusion who did not receive reperfusion, and underwent repeated perfusion imaging, with baseline imaging < 6 h after onset and follow-up scans from 16–168 h. A persistent target mismatch (PTM) was defined as core volume of < 100 mL, mismatch ratio > 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.
- Subject
- persistent large penumbra; little core growth; good collateral flow; CT perfusion image; CT perfusion collateral index; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1465798
- Identifier
- uon:47376
- Identifier
- ISSN:1869-1439
- Rights
- This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
- Language
- eng
- Full Text
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