Value of Perfusion CT-Guided Recanalization Therapy in Acute Ischemic Stroke Patients

Discussion To date, the key determinant of patient selection for reperfusion therapy has been the time since stroke onset [5] . However, the progression of irreversible injury is highly variable between individuals. Some patients may present a malignant profile with a high risk for brain hemorrhage shortly after recanalization therapy [1] . Although MRI is the reference for identifying these patients, a stroke CT workup is frequently achieved. However, noncontrast CT scans often appear normal up to 6 h after the onset of brain ischemia. Conversely, PCT has the potential to improve patient selection, as illustrated by Zhu et al. [2] . In a recent large study, PCT findings seemed to represent independent information which could neither be predicted by clinical, noncontrast CT nor CTA data [2] . Based on this, PCT could be systematically added to noncontrast CT and CTA in order to identify subgroups of patients who are at increased risk for hemorrhage and poor clinical outcomes [4] .