A significant complication in the intervention of acute ischaemic stroke is haemorrhagic transformation. It has been postulated that perfusion permeability imaging showing increased blood brain barrier permeability can be used to predict haemorrhagic transformation and possibly alter therapies.Materials and Methods
We retrospectively reviewed 60 CT perfusion scans with permeability surface area product maps calculated using the Patlak model where IV tPA or endovascular thrombectomy was performed at our institution in 2012.Results
Permeability maps were positive in 31 of the 60 cases. The size of the permeability change was medium to large in 29 of 31 cases (94%). Of the positive permeability cases only two (6%) subsequently developed haemorrhagic transformation (HT). One was a PH2 haemorrhage and one a HI2 haemorrhage. Both cases where HT occurred were successful (TICI 2b/3) endovascular thrombectomies. Neither of these cases developed malignant oedema, required hemicraniotomy or other intervention. No difference was found in the size or degree of the permeability changes and the incidence of HT.Conclusion
Elevated permeability on CT perfusion imaging had no relevant predictive value for haemorrhagic transformation in acute ischaemic stroke interventions at our institution.Disclosures
A. Matthews: None. M. Parker: None. N. Rutledge: None. K. Conrad: None. J. Luci: None. B. Bluett: None.