Selection by Noncontrast Computed Tomography With or Without Computed Tomography Angiography Versus Computed Tomography Perfusion for Endovascular Therapy in Patients With Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis Article Swipe
Yang Zhang
,
Yang Zhao
,
Bowen Deng
,
Simiao Wu
,
Raul G. Nogueira
,
Mohamad Abdalkader
,
Simon Nagel
,
Patrik Michel
,
Zhongming Qiu
,
Qingwu Yang
,
Zhongrong Miao
,
Xiaochuan Huo
,
Dapeng Sun
,
Amrou Sarraj
,
Bruce Campbell
,
Chuansheng Zhao
,
Wenhuo Chen
,
Tingyu Yi
,
Wei Bian
,
Thanh N. Nguyen
,
Yi Sui
,
Haiyuan Wang
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1161/jaha.124.038173
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1161/jaha.124.038173
Background The effect of imaging selection on endovascular therapy for acute ischemic stroke remains debated. We compared the efficacy and safety of imaging modalities using computed tomography perfusion with using noncontrast computed tomography (NCCT)±computed tomography angiography. Methods Studies from PubMed, Embase, and Cochrane Library up to March 1, 2024, were analyzed. Sixteen studies (12 199 patients) assessed functional independence (modified Rankin Scale score of 0–2 at 90 days) using odds ratios (ORs). This study was registered with the International Prospective Register of Systematic Reviews (CRD42024519554). Results No significant differences were observed in functional independence (OR, 1.09 [95% CI, 0.98–1.21]), modified Rankin Scale score of 0 to 1 (OR, 1.07 [95% CI, 0.88–1.29]), 0 to 3 (OR, 1.04 [95% CI, 0.92–1.18]), thrombolysis in cerebral infarction 2b to 3 (OR, 1.08 [95% CI, 0.95–1.22]), symptomatic intracranial hemorrhage (OR, 0.87 [95% CI, 0.74–1.04]), and any intracranial hemorrhage (OR, 0.95 [95% CI, 0.80–1.12]) between the computed tomography perfusion and NCCT group. There was a significantly lower odds of death during follow‐up in the computed tomography perfusion group compared with the NCCT group (OR, 0.78 [95% CI, 0.70–0.88]). Comparison of modified Rankin Scale score of 0 to 2 significantly favored NCCT selection for patients with large cores ( P interaction =0.05). Risk of bias assessment using the Cochrane risk assessment tool revealed concerns in 1 randomized control trial, while observational and post hoc studies assessed with Risk of Bias in Nonrandomized Studies of Interventions I showed moderate (2 studies), serious (11 studies), and critical (2 studies) risk of bias. Conclusions These findings indicate that patients undergoing endovascular therapy selected with computed tomography perfusion had a similar functional prognosis compared with those selected with NCCT but had lower odds of death during follow‐up. NCCT‐defined large‐core patients had better functional outcomes.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1161/jaha.124.038173
- OA Status
- gold
- Cited By
- 1
- References
- 59
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4411214089
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4411214089Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1161/jaha.124.038173Digital Object Identifier
- Title
-
Selection by Noncontrast Computed Tomography With or Without Computed Tomography Angiography Versus Computed Tomography Perfusion for Endovascular Therapy in Patients With Acute Ischemic Stroke: A Systematic Review and Meta‐AnalysisWork title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-06-11Full publication date if available
- Authors
-
Yang Zhang, Yang Zhao, Bowen Deng, Simiao Wu, Raul G. Nogueira, Mohamad Abdalkader, Simon Nagel, Patrik Michel, Zhongming Qiu, Qingwu Yang, Zhongrong Miao, Xiaochuan Huo, Dapeng Sun, Amrou Sarraj, Bruce Campbell, Chuansheng Zhao, Wenhuo Chen, Tingyu Yi, Wei Bian, Thanh N. Nguyen, Yi Sui, Haiyuan WangList of authors in order
- Landing page
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https://doi.org/10.1161/jaha.124.038173Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://doi.org/10.1161/jaha.124.038173Direct OA link when available
- Concepts
-
Medicine, Computed tomography, Radiology, Computed tomography angiography, Tomography, Perfusion scanning, Computed tomographic angiography, Angiography, Meta-analysis, Perfusion, Stroke (engine), Internal medicine, Engineering, Mechanical engineeringTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
1Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1Per-year citation counts (last 5 years)
- References (count)
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59Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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