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May 15, 2019

ESOC-2019

BLOOD FLOW CHARACTERISTICS IN THE VICINITY OF A THROMBUS IN ACUTE ISCHEMIC STROKE

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dynamic cta

blood flow characteristics

thrombus permeability

ischemic stroke

Abstract

Abstract

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Keywords

dynamic cta

blood flow characteristics

thrombus permeability

ischemic stroke

Abstract

Background and aims Thrombus permeability has been associated with patient outcome in acute ischemic stroke. Permeable thrombi allow the passage of residual fluid, which results in anterograde flow distal to the thrombus. Retrograde flow distal to a thrombus has been associated with collateral flow. We propose a method to further characterize flow characteristics in the vicinity of a thrombus. We identify antegrade and retrograde flow, and quantify blood transit-time and velocity on dynamic CTA. Methods The dynamic attenuation of contrast intensity proximal to, within and distal to the thrombus, within the artery, was measured. We identified cases with antegrade and retrograde flow by comparing the time delay between time attenuation curves (TACs). Additionally, using TACs, we computed blood transit-time and velocity within the thrombus. Results Analysis of 49 patients from the DUST and the Amsterdam UMC showed that 18 patients had anterograde flow and 9 patients had retrograde flow. In 11 patients, a combination of both flows was observed. The remaining 11 patients had fast flow. The median blood transit-time was 2.12 (0.83-3.99) s. The median blood velocity was 0.58 (0.26-1.35) cm/s. Conclusion Flow in the vicinity of thrombi differs significantly between patients, but is for all cases slow. This finding could be of value in treatment decisions with regard to the use of IV-rtPA.

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© Copyright 2019 Morressier GmbH.
All rights reserved.