Post-diffusion and perfusion magnetic resonance imaging of emboli to distal territories after endovascular thrombectomy.

BACKGROUND AND PURPOSE

This study aimed to investigate the clinical outcomes of emboli to distal territories (EDT) after aspiration thrombectomy in patients with acute anterior circulation occlusion.

MATERIALS AND METHODS

From January 2016 to December 2022, all eligible patients who underwent endovascular treatment (EVT) due to acute anterior circulation occlusion were retrospectively reviewed. During this period, patients with EDT after EVT underwent magnetic resonance (MR) perfusion with angiography and diffusion-weighted imaging within 12 hours from recanalization. Hypoperfusion was defined as a Tmax value > 6-second volume.

RESULTS

Of the 104 eligible patients (65 males, median age 74 years), 79 (76.0 %; 2a: 19, 2b: 55, 2c: 5) had hypoperfusion on perfusion MR (PWI). Complete mismatch on diffusion-weighted imaging (DWI) of the hypoperfusion area was significantly higher in patients with successful recanalization than in patients with incomplete recanalization (58.3 % vs. 31.6 %, p = 0.0437). Of the 79 patients with hypoperfusion, 24 had EDT in the M2, 39 in the M3, and 16 in the M4. Complete mismatch on DWI and PWI was significantly higher in patients with a distal EDT (M3 or M4) than in patients with an M2 EDT (65.8 % vs. 20.8 %, p < 0.001).

CONCLUSIONS

EDT to the M3 or more distal branches after EVT had a higher rate of complete DWI-PWI mismatch on early follow-up MRI than EDT to M2.

Informations de copyright

Copyright © 2023. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest None of the authors have potential conflict of interest including any financial, personal or other relationships with other people or organizations that could inappropriately influence this work.