ABSTRACT
Background and Purpose
Prolonged venous transit (PVT), derived from computed tomography perfusion (CTP) time-to-maximum (T
max) maps, reflects compromised venous outflow (VO) in acute ischemic stroke due to large vessel occlusion (AIS-LVO). Poor VO is associated with worse clinical outcomes, but pre-treatment markers predictive of PVT are not well described.
Methods
We conducted a retrospective analysis of 189 patients with anterior circulation AIS-LVO who underwent baseline CT evaluation, including non-contrast CT, CT angiography, and CTP. PVT was assessed on T
max maps; PVT+ was defined as T
max ≥ 10 s within the posterior superior sagittal sinus or torcula. Baseline clinical data were collected. Multivariable logistic regression identified independent associations between pre-treatment markers and PVT.
Results
PVT+ was identified in 65 patients (34%). In multivariable analysis, higher admission National Institutes of Health Stroke Scale (NIHSS) scores (adjusted odds ratio [aOR], 1.05 per point; 95% confidence interval [CI], 1.01–1.11; P = 0.028) and male sex (aOR, 1.98; 95% CI, 1.03–3.89; P = 0.043) were independently associated with PVT+.
Conclusions
Higher admission NIHSS scores and male sex are independently associated with PVT in anterior circulation AIS-LVO, suggesting that readily available clinical markers may help identify patients with poor VO profiles.
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This post is Copyright: Hamza Adel Salim,
Dhairya A. Lakhani,
Aneri B. Balar,
Janet Mei,
Licia Luna,
Mona Shahriari,
Nathan Z. Hyson,
Francis Deng,
Adam A. Dmytriw,
Adrien Guenego,
Victor C. Urrutia,
Elisabeth B. Marsh,
Hanzhang Lu,
Risheng Xu,
Rich Leigh,
Gaurang Shah,
Sijin Wen,
Gregory W. Albers,
Argye E. Hillis,
Rafael Llinas,
Kambiz Nael,
Max Wintermark,
Jeremy J. Heit,
Tobias D. Faizy,
Vivek S. Yedavalli | January 15, 2025
Wiley: Journal of Neuroimaging: Table of Contents