Prediction of Stent-Retriever Thrombectomy Outcomes by Dynamic Multidetector CT Angiography in Patients with Acute Carotid T or MCA Occlusions

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Fig 1.
Occlusion-length measurement. Temporal MIP images show the occluding thrombus as a filling defect. A, Axial temporal MIP image of a left-sided carotid T occlusion. B and C, Axial and sagittal images of a right-sided M1 occlusion.
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Fig 2.
Flow chart of patient selection. dynCTA indicates dynamic CT angiography.
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Fig 3.
Correlation between dynamic CTA predictors and angiographic outcome. Shorter occlusion length (A) is associated with favorable technical thrombectomy outcome. Both collateralization grade (B) and time delay (C) do not show a significant correlation with angiographic thrombectomy outcome.

Table 1:

Characteristics of patients with favorable (mTICI = 3) and nonfavorable (mTICI < 3) recanalization outcome^{^a}

	Overall (N = 69)	mTICI = 3 (n = 31)	mTICI < 3 (n = 38)	Odds Ratio	P Value
Age (yr)	68.4 ± 14.4	66.7 ± 14.1	69.8 ± 14.5	1.000	.981
Male sex (No.)	32 (46%)	15 (48%)	17 (45%)	1.152	.775
Additional ICA occlusion (No.)	22 (32%)	9 (29%)	13 (34%)	0.708	.485
Carotid T occlusion (No.)	19 (28%)	5 (16%)	14 (37%)	1.768	.274
Time to recanalization (min)	119 ± 82	108 ± 69	127 ± 92	0.859	.389
IVT (No.)	54 (78%)	24 (77%)	30 (79%)	1.094	.878
Occlusion length (mm)	15.6 ± 7.9	12.9 ± 6.8	17.7 ± 8.1	0.409	.018^{^b}
Collateralization grade (0–20)	13.8 ± 4.3	13.7 ± 4.5	13.7 ± 4.1	1.003	.958
Time delay (sec)	6.5 ± 2.8	6.2 ± 2.1	6.7 ± 3.2	0.896	.251

↵a The last 2 columns show the results of the univariate logistic regression analysis to determine the effect of predictors on recanalization success (N = 69).
↵b Statistically significant.

Table 2:

Characteristics of patients with favorable (mRS_disc ≤ 2) and nonfavorable (mRS_disc > 2) clinical outcome^{^a}

	Overall (N = 69)	mRS_disc ≤ 2 (n = 17)	mRS_disc > 2 (n = 52)	Odds Ratio	P Value
Age (yr)	68.4 ± 14.4	65.4 ± 16.5	69.4 ± 13.8	0.982	.380
Male sex (No.)	32 (46%)	7 (41%)	25 (48%)	0.877	.839
Additional ICA occlusion (No.)	22 (32%)	4 (23%)	18 (35%)	0.960	.949
Carotid T occlusion (No.)	19 (28%)	6 (35%)	13 (25%)	1.023	.974
Time to recanalization (min)	119 ± 82	101 ± 77	126 ± 86	0.694	.181^{^b}
IVT (No.)	54 (78%)	15 (88%)	39 (75%)	0.202	.142^{^b}
Occlusion length (mm)	15.6 ± 7.9	13.6 ± 7.4	16.1 ± 8.2	0.664	.330
Collateralization grade (0–20)	13.8 ± 4.3	13.9 ± 4.5	13.8 ± 4.2	0.996	.953
Time delay (sec)	6.5 ± 2.8	6.7 ± 3.2	6.4 ± 2.8	1.011	.917

Note:—mRS_disc indicates mRS at discharge.
↵a The last 2 columns show the results of the univariate logistic regression analysis to determine the effect of predictors on clinical outcome (N = 69).
↵b Below < .2 and therefore included in multivariate analysis.