C-arm Cone Beam CT Perfusion Guided Cerebrovascular Interventions

This is an evaluation to determine the efficacy of the use of C-arm CBCT with SMART RECON
novel software for the rapid assessment of time-resolved CTA and CT perfusion in the setting
of ischemic cerebrovascular events. As a leading center for the treatment of cerebrovascular
disease in the Midwest as well as being one of the first Comprehensive Stroke Centers in the
United States we have a large potential patient group to assess. Our pilot plan is to compare
conventional CT/CTA/CTP acquired during the clinical work up with C-arm CBCT/CTA/CTP acquired
in the angiography suite at initiation of therapy. The C-arm CBCT acquisition provides whole
brain coverage (compared to only 8 cm brain coverage with conventional CT) with less
radiation and higher resolution; the CT perfusion maps obtained using C-arm CBCT and new
reconstruction algorithms provides better perfusion maps.

Inclusion Criteria:

1. Patients with acute ischemic stroke presenting within 8 hours of onset

2. Patients that present with a large artery occlusion

3. Adults 18 years of age or older.

4. Women of childbearing potential must not be pregnant.

5. National Institutes of Health Stroke Scale (NIHSS) of >5

6. No severe co-morbidities

Exclusion Criteria:

1. Women that are pregnant

2. History of severe renal disease (e.g. stage 4-5)

3. History of renal transplant