title: Fate of the penumbra after mechanical thrombectomy.
abstract: OBJECTIVE
  In acute stroke, CTP is often used to visualize the endangered brain areas, including the ischemic core and the penumbra. Our goal was to assess the evolution of the infarct after mechanical thrombectomy and to analyze the interventional factors determining the fate of the penumbra.
  
  
  METHODS
  All patients receiving mechanical thrombectomy in the anterior circulation and receiving CTP beforehand were identified. The infarct volume was specified. The clinical parameters, outcome, and interventional results were correlated with the CTP and the final infarct size.
  
  
  RESULTS
  In total, 73 patients were included. After mechanical thrombectomy, 78.1% reached a TICI score of 3/2b. The final infarct volume was significantly smaller, with a TICI score of 3/2b compared with less sufficient recanalization (19.60 ± 3 cm(3) versus 38.1 ± 9 cm(3); P < .001). After TICI 3/2b recanalization, 81% ± 5.2% of the potential infarct size (calculated as the sum of infarct core and penumbra) could be rescued. In patients with TICI scores of 2a or worse, only 39 ± 28.3 were salvaged (P < .001). The Alberta Stroke Program Early CT Score after successful recanalization TICI score of 3/2b resulted in a decline of 1.9 ± 1.4 compared with the significantly higher degradation score of 3.7 ± 1.7 after recanalization, with a TICI score of 2a or worse. A recanalization TICI score of 3/2b resulted in an NIHSS improvement of 7.3 ± 0.8 NIHSS points, whereas a poorer recanalization improved on the NIHSS by only 2.5 ± 1.5 points (P < .01).
  
  
  CONCLUSIONS
  Mechanical thrombectomy is a potent method to rescue large areas of penumbra in acute stroke.
authors.affiliation: From the Departments of Neuroradiology (B.F., O.K., D.B., C.Z., S.P., A.F.) benjamin.friedrich@tum.de.
authors.forename: B
authors.initials: B
authors.lastname: Friedrich
authors.affiliation: From the Departments of Neuroradiology (B.F., O.K., D.B., C.Z., S.P., A.F.).
authors.forename: O
authors.initials: O
authors.lastname: Kertels
authors.affiliation: From the Departments of Neuroradiology (B.F., O.K., D.B., C.Z., S.P., A.F.).
authors.forename: D
authors.initials: D
authors.lastname: Bach
authors.affiliation: Neurology (S.W.), Klinikum Rechts der Isar, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Wunderlich
authors.affiliation: From the Departments of Neuroradiology (B.F., O.K., D.B., C.Z., S.P., A.F.).
authors.forename: C
authors.initials: C
authors.lastname: Zimmer
authors.affiliation: From the Departments of Neuroradiology (B.F., O.K., D.B., C.Z., S.P., A.F.).
authors.forename: S
authors.initials: S
authors.lastname: Prothmann
authors.affiliation: From the Departments of Neuroradiology (B.F., O.K., D.B., C.Z., S.P., A.F.).
authors.forename: A
authors.initials: A
authors.lastname: Förschler
mesh_terms: D000368:Aged; D002533:Cerebral Angiography / Q000379:methods*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis; D011379:Prognosis; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome