Synchronous Superficial Middle Cerebral Vein Outflow Correlates Favorable Tissue Fate After Mechanical Thrombectomy for Acute Ischemic Stroke

Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved..

RATIONALE AND OBJECTIVES: The purpose of this study was to determine the association between hemispheric synchrony in venous outflow at baseline and tissue fate after mechanical thrombectomy (MT) for acute ischemic stroke (AIS).

MATERIALS AND METHODS: A two-center retrospective analysis involving AIS patients who underwent MT was performed. The four cortical veins of interest include the superficial middle cerebral vein (SMCV), sphenoparietal sinus (SS), vein of Labbé (VOL), and vein of Trolard (VOT). Baseline computed tomography perfusion data were used to compare the following outflow parameters between the hemispheres: first filling time (△FFT), time to peak (△TTP) and total filling time (△TFT). Synchronous venous outflow was defined as △FFT = 0. Multivariable regression analyses were performed to evaluate the association of venous outflow synchrony with penumbral salvage, infarct growth, and intracranial hemorrhage (ICH) after MT.

RESULTS: A total of 151 patients (71.4 ± 13.2 years, 65.6% women) were evaluated. Patients with synchronous SMCV outflow demonstrated significantly greater penumbral salvage (41.3 mL vs. 33.1 mL, P = 0.005) and lower infarct growth (9.0 mL vs. 14.4 mL, P = 0.015) compared to those with delayed SMCV outflow. Higher △FFTSMCV (β = -1.44, P = 0.013) and △TTPSMCV (β = -0.996, P = 0.003) significantly associated with lower penumbral salvage, while higher △FFTSMCV significantly associated with larger infarct growth (β = 1.09, P = 0.005) and increased risk of ICH (odds ratio [OR] = 1.519, P = 0.047).

CONCLUSION: Synchronous SMCV outflow is an independent predictor of favorable tissue outcome and low ICH risk, and thereby carries the potential as an auxiliary radiological marker aiding the treatment planning of AIS patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:31

Enthalten in:

Academic radiology - 31(2024), 4 vom: 30. Apr., Seite 1548-1557

Sprache:

Englisch

Beteiligte Personen:

Dai, Lisong [VerfasserIn]
Sun, Zheng [VerfasserIn]
Jiang, Jingxuan [VerfasserIn]
Wei, Jianyong [VerfasserIn]
Song, Xinyu [VerfasserIn]
Chen, Shen [VerfasserIn]
Li, Yuehua [VerfasserIn]

Links:

Volltext

Themen:

Brain infarction
Cerebrovascular circulation
Journal Article
Perfusion imaging
Thrombectomy
X-ray computed tomography

Anmerkungen:

Date Completed 15.04.2024

Date Revised 15.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.acra.2023.07.005

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM360415172