The use of CT angiogram (CTA) and CT perfusion (CTP) increased considerably among patients with acute ischemic stroke between 2006 and 2010, a study published online Feb. 25 in Stroke found.
Researchers from the University of Cincinnati Medical Center reviewed data from the Premier Perspective Database, which includes information on hospitalizations related to ischemic stroke. They identified what factors predicted imaging studies and reperfusion.
CTA increased each year during the specified time period, from 3.8 percent in 2006 to 9.1 percent in 2010. CTP also increased, from 0.05 percent in 2006 to 2.9 percent in 2010. CTA and CTP were also associated with more reperfusion treatment compared with head CTs alone (13 percent and 17.6 percent, respectively, compared with 4 percent). CTA and CTP were also associated with higher rates of recombinant tissue-type plasminogen activator compared with CT alone (10.2 percent and 11.4 percent, respectively, vs. 3.8 percent). Mechanical embolectomy was also more frequent with CTA (2.8 percent) and CTP (6.3 percent) compared with CT alone (0.2 percent).
Based on their findings, the authors stressed the need for clinical trials involving CT-based multimodal imaging selection.
“Given limited healthcare resources, the well-publicized risks of increased radiation, along with limited evidence for clinical benefit of this approach, it becomes imperative that CT-based multimodal imaging selection for acute ischemic strokes be studied in controlled clinical trials,” they wrote.