Feasibility study in the combination of non-contrast computed tomography and transcranial Doppler for large vessel occlusion detection

Abstract

Background and purpose: Accurate detection of Large Vessel Occlusion (LVO), and subsequent assessment of candidacy for endovascular intervention, present challenging clinical obstacles to efficient stroke patient triage, especially when computed-tomography angiogram (CTA) is not readily available especially in non-primary or comprehensive stroke centers. The Alberta Stroke Program Early CT Score (ASPECTS) is used to evaluate a patient's non-contrast CT (NCCT) exam for evidence of cerebral tissue damage and provides information about the tissue affected by stroke to determine course of treatment. Velocity curvature index (VCI) is a biomarker derived from the morphological analysis of transcranial Doppler (TCD) waveforms and has shown utility in TCD assessment of LVO. The purpose of this study was to evaluate the relationship between ASPECTS and VCI and to explore their combined diagnostic capabilities. We hypothesized that ASPECTS' assessment of LVO can be augmented with TCD imaging modality for the purpose of faster door-to-intervention workflow and triage of LVO patients to stroke centers.