A Retrospective Study of CT (Computerized Tomography) for Late Window Large Vessel Occlusion (LVO)
The objective of this multicenter, retrospective, cross-sectional, chart review study is to compare outcomes (disability, complications and mortality) of patients with large vessel occlusion stroke presenting at late time window selected by either Non-Contrast CT (NCCT) only, advanced imaging with CTP (Computed Tomography Perfusion), MRI (Magnetic Resonance Imaging), or medical management. Boston Medical Center (BMC) will serve as the main data coordinating site. Twelve additional sites will seek local IRB approval and execute data use agreements with BMC. The aggregated de-identified data will be analyzed comparing types of interventions and outcomes by type of imaging or medical management.
- Stroke, Cardiovascular
- Eligible Ages
- Over 18 Years
- Eligible Genders
- Accepts Healthy Volunteers
- Patients presenting 6-24 hours from last known well with large vessel occlusion stroke - ASPECTS score 5 or greater from last known well - January 1, 2014 to December 2020
- Patients who have large vessel occlusion stroke of the posterior circulation - Time last seen well to treatment <6 hours from last known well
- Study Type
- Observational Model
- Time Perspective
- Boston Medical Center
Additional subgroup analysis that are planned include: 1. Futile Reperfusion in the Extended Window. We will evaluate clinical, imaging and time metric factors associated with successful reperfusion yet poor outcomes (modified Rankin 3-6) in the 6-24 hour window. An evaluation of factors associated with symptomatic intracranial hemorrhage and mortality will be conducted. 2. Transfer Analysis It is not well established whether transfer patients presenting in the extended window should have repeat imaging upon receipt at the endovascular center after an interim time window. We hypothesize that within a 0 to 2, or 2 to 4 hour delay between images of the primary stroke center to receiving endovascular center, transferred patients in the extended window, who undergo thrombectomy with successful reperfusion will have similar outcomes in patients with or without repeat imaging at the receiving center. 3. Patients with pre-existing disability, defined as pre-stroke disability modified Rankin score of 3 to 4.