Page 22

1697_AX_Kundenmagazin_CC.indd

Stroke – Thrombectomy Supported by syngo iFlow Courtesy of Beverly Aagaard-Kienitz, MD, and Charles Strother, MD Department of Radiology, University of Wisconsin School of Medicine and Public Health Madison/Wisconsin, USA Patient History A 49-year-old left handed woman with sudden onset of left hemiplegia noted to have a right M1 MCA occlusion on a CT angiogram. Five hours after stroke onset and two hours after IV tPA the patient was transferred to neurointerventional radiology for further treatment. Diagnosis Cerebral angiogram shows complete occlusion of the M1 segment of the right MCA. No other abnormalities were present. Treatment Following a combination of mechanical thrombectomy using a penumbra aspiration device and thrombolysis, the final angiogram demonstrates only a small distal thromboemboli with the angular artery. Comments The initial CT Perfusion scan showed a reduced CBF and a prolonged TTP and MTT in the territory of the right M1. Using syngo iFlow very slow flow was seen in the arteries supplying the tissue shown to have abnormal CBF, TTP and MTT on the PCT. After successful recanalization the final angiogram with syngo iFlow applied demonstrated significant improvement in blood flow in these arteries as compared to the initial study. 1 The pre-treatment CT Perfusion scan shows reduced CBF and prolonged TTP and MTT in the distribution of the right MCA. The green time attenuation curve on the top shows the TTP in the ROI indicated by the red circle. The green time attenuation curve on the bottom shows the TTP in the ROI indicated by the black ellipse. There is a 6.2 sec. delay in TTP in the ischemic tissue. The curve from the ROI in the ischemic tissue also shows that there is slower wash out of contrast in this region than from the tissue in ROI placed over normal tissue. 1 Angiography Stroke 22  AXIOM Innovations | December 2013 | www.siemens.com/angiography


1697_AX_Kundenmagazin_CC.indd
To see the actual publication please follow the link above