Journal article
Computed tomographic perfusion predicts poor outcomes in a randomized trial of endovascular therapy
R Wannamaker, T Guinand, BK Menon, A Demchuk, M Goyal, D Frei, A Bharatha, TG Jovin, J Shankar, T Krings, B Baxter, C Holmstedt, R Swartz, D Dowlatshahi, R Chan, D Tampieri, H Choe, P Burns, N Gentile, J Rempel Show all
Stroke | LIPPINCOTT WILLIAMS & WILKINS | Published : 2018
Abstract
Background and Purpose-In the ESCAPE trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion with Emphasis on Minimizing CT to Recanalization Times), patients with large vessel occlusions and small infarct cores identified with computed tomography (CT)/CT angiography were randomized to endovascular therapy or standard of care. CT perfusion (CTP) was obtained in some cases but was not used to select patients. We tested the hypothesis that patients with penumbral CTP patterns have higher rates of good clinical outcome. Methods-All CTP data acquired in ESCAPE patients were analyzed centrally using a semiautomated perfusion thresholdbased approach. A penumbral pa..
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Funding Acknowledgements
Dr Butcher received salary support from Canada Research Chairs program and Heart and Stroke Foundation of Alberta, Northwest Territories and Nunavut (NWT and NU). T. Guinand received salary support from Quality Improvement and Clinical Research Alberta Stroke Program. Dr Baxter received personal fees from Covidien, Penumbra, Stryker Neurovascular, Silk Road Medical, Reverse Medical, Rapid Medical, Concentric Medical, and Codman Medical and has a patent related to a neuronal protection system (US 8 622 992). Dr Demchuk received personal fees and grant support from Covidien. Dr Frei received personal fees from Covidien and Penumbra outside the submitted work. Dr Goyal received grant support and personal fees from Covidien pending patent related to systems and methods for diagnosing strokes (WO 2014/036638) and licensed to GE Healthcare. Dr Hill received grant support from Covidien, the Calgary Stroke Program, the Hotchkiss Brain Institute, the University of Calgary, the Heart and Stroke Foundation of Alberta, NWT, NU, and Alberta Innovates Health Solutions, personal fees from Merck, and nonfinancial support from Hoffmann-La Roche Canada, has a pending patent related to systems and methods for assisting in decision making and triaging for acute stroke patients (US patent office number 62/086,077), and holds stock ownership in Calgary Scientific, Inc. Dr Holmstedt received grant support from National Institutes of Health (NIH)/National Institute of General Medical Sciences (NIGMS), AstraZeneca, Genentech, Penumbra, the NIH/National Institute of Neurological Disorders and Stroke (NINDS), Remedy, Edwards Lifesciences LLC, the South Carolina Clinical and Translational Research Institute/Clinical Translational Science Award, and Stryker, grant support and personal fees from Covidien, and personal fees from CE Outcomes, Inc. Dr Jovin acts as an investor/advisor at Route 92, Anaconda, FreeOX Biotech, Blockade Medical, Silk Road and as a consultant at Cerenovus, Stryker Neurovascular. The other authors report no conflicts.