The following is a summary of “High relative cerebral blood volume is associated with good long term clinical outcomes in acute ischemic stroke: a retrospective cohort study,” published in the August 2024 issue of Neurology by Strinitz et al.

Relative cerebral blood volume (rCBV), a rapid and objective measure of cerebral blood volume, could streamline the assessment of collateral flow and improve patient selection for endovascular therapy in acute ischemic stroke.

Researchers conducted a retrospective study assessing if rCBV is correlated to better outcomes in patients with ischemic stroke after prior endovascular therapy. 

They reviewed patient records from January 2017 and May 2019, focusing on anterior circulation strokes treated with mechanical thrombectomy (MT) and CT perfusion imaging. The RAPID software was used to calculate rCBV and analyze outcomes with the modified Rankin Scale (mRS) after 90 days, using regression and receiver operating characteristic (ROC) analysis to find predictive cutoff values. Good clinical outcome was defined as mRS ≤ 2.

The results studied 155 patients, with 66 patients (42.58%) showing good clinical outcomes. A high rCBV was linked to better outcomes (P<0.001), even after adjusting for mRS, National Institute of Health Stroke Scale (NIHSS), age, and Alberta stroke program early computed tomography score (ASPECTS) (P=0.006). The ROC analysis identified 0.650 as the optimal cutoff value (CI: 0.616-0.778). 

Investigators concluded that higher baseline rCBV was linked to better long-term outcomes in patients treated with MT, supporting the use of rCBV as a valuable tool for identifying patients who could benefit from MT, even in borderline cases.

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03806-w