Preoperative Risk Prediction of Hyperperfusion Cerebral Hemorrhage for Stenting of Severe Stenosis of Middle Cerebral Artery Based on DSA and CTPI
Objective Prediction of preoperative risk of high perfusion cerebral hemorrhage(HICH)for stenting of severe middle cerebral artery stenosis based on digital subtraction angiography(DSA)and cerebral CT perfusion imaging(CTPI).Methods One hundred and fifty-three patients with severe stenosis of the middle cerebral artery(70％to 99％stenosis)treated with stent implantation were selected,of whom,5 developed HICH(HICH group)and 148 did not develop HICH(non-HICH group).Comparative analysis of clinical baseline data,CTPI,and DSA cerebral arterial tertiary collateral circulation compensation between the two groups of patients.Measurement data were compared using t-test,and counting data were compared using Fisher test.Results Comparison of various indicators between HICH group and non-HICH group,patients had a time from onset to surgery≤21 d(P<0.05);mean transit time(MTT)and time to peak(TTP)(P<0.05),rMTT and rTTP(P<0.001);the difference between non open collateral circulation and open level Ⅲ collateral circulation was statistically significant(P<0.05).Conclusion Clinical baseline data(time from onset to surgery≤21 d),CTPI indices(MTT,TTP,rMTT,rTTP),and cerebral arterial collateral circulation compensation status(grade Ⅲ collateral circulation open,collateral circulation unopened)can be used as predictors of implantation of hyperperfusion cerebral hemorrhage with severe stenosis of the middle cerebral artery.
stenting for severe stenosis of middle cerebral arteryhigh perfusion intracerebral hemorrhageDSA class Ⅲ collateral circulationCT perfusion imaging of the brainrisk prediction
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