PeRfusiOn Post tHrombEcTomy (PROPHET) - A technical development and clinical validation project

Mechanical thrombectomy (MT) is the highly effective standard of care for acute ischemic stroke with large vessel occlusion. However, up to 50% of patients experience "futile recanalization," where successful macrovascular recanalization does not translate into functional recovery. To assess the reperfusion status of treated patients the implementation of a functional FP-CTP acquisition and post-processing was established in order to evaluate patients’ reperfusion status directly in the operating room. Within the scope of a multi-center project using this processing, we were able to show that perfusion imaging can distinguish different reperfusion phenotypes in treated patients, which can be used to stratify patients for further interventional or medical treatments in the acute stroke phase. We were able to show that acute acquisition is feasible, an immediately available post-processing algorithm can provide perfusion maps comparable to standard perfusion modalities and that these maps help to define the reperfusion status of patients in more detail than standard techniques.