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Abstract
Objective: To evaluate whether earlier CTA assessment is associated with favorable clinical outcomes and reduced in-hospital mortality.
Materials & Methods: A retrospective study of 163 acute ischemic stroke patients was conducted at the University Of Lahore Teaching Hospital Care Center from April 2025 to July 2026. All patients underwent CT angiography within 24 hours of symptom onset to assess vascular abnormalities, particularly large-vessel occlusion and collateral circulation. CTA images were reviewed by two experienced neuroradiologists. Clinical outcomes were assessed using the modified Rankin Scale (mRS). Data were analyzed using appropriate statistical tests, with p < 0.05 considered statistically significant. The study evaluated the usefulness of early CTA for diagnosis, treatment planning, and prediction of clinical outcomes in acute ischemic stroke.
Results: Among 163 patients, the mean age was 63.5 ± 8.5 years, with males predominating (59.50%) over females (40.49%). Hypertension (75.46%) was the most common risk factor, followed by diabetes mellitus (36.19%) and dyslipidemia (25.15%). The mean time to CTA was 5.1 hours. CTA identified large-vessel occlusion in 80 patients (49.07%). Collateral circulation was mild in 24.53%, moderate in 45.39%, and severe in 30.06%, with 74.85% demonstrating moderate-to-severe collateral circulation. Incidental vascular anomalies were found in 10.42% of patients. Clinically, 53.37% achieved favorable outcomes, while 14.72% died during hospitalization. Overall, the findings highlight the importance of early CTA for detecting large-vessel occlusion and assessing collateral circulation in acute ischemic stroke.
Conclusion: CT angiography is a valuable imaging modality for early stroke diagnosis, enabling rapid detection of large-vessel occlusion and collateral circulation. Early CTA supports timely treatment decisions and may improve clinical outcomes.