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Evidence to Improve Care

Automated CT Perfusion Imaging to Aid in the Selection of Patients With Acute Ischemic Stroke for Mechanical Thrombectomy

Final Recommendation

  • Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends publicly funding mechanical thrombectomy within 24 hours of acute ischemic stroke, and that automated CT perfusion imaging is an important tool to facilitate patient selection

Read the final recommendation report


A stroke happens when blood suddenly stops flowing to a part of the brain, causing damage to brain cells. Restoring blood flow within 24 hours after the stroke can reduce the damage and improve health outcomes.

For people who have an ischemic stroke (when a blood clot develops in an artery in the brain), one method to restore blood flow is to remove the clot (a procedure called mechanical thrombectomy). But this procedure may not be appropriate for everyone. To identify patients who would benefit from this procedure, hospitals use medical imaging such as MRI (magnetic resonance imaging) or CT scans (computed tomography). Although MRI is the most accurate option, it is not always available in small or rural hospitals. When MRI is not available, CT scanners can be used. Brain images acquired from CT scans can be automatically processed by computer. With automated CT perfusion imaging, the results can be reviewed and communicated quickly.

This health technology assessment looked at how effective automated CT perfusion imaging is in identifying eligible patients for mechanical thrombectomy. It also looked at the cost-effectiveness and budget impact of publicly funding automated CT perfusion imaging.

Read the full health technology assessment report for more information.

Automated CT Perfusion Imaging to Aid in the Selection of Patients With Acute Ischemic Stroke for Mechanical Thrombectomy: A Health Technology Assessment (PDF)
November 2020

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The Ministry of Health endorses this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review health technology assessments and funding recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.



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