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Post-ischemic vasodynamic changes in infarcted brain parenchyma are common and range from hypo- to hyperperfusion. In the present study, appearance of the lenticulostriate arteries (LSAs) on postinterventional 3T time-of-flight (TOF)-MRA suggestive for altered post-stroke vasodynamics following thrombectomy was investigated. Patients who underwent thrombectomy for a proximal MCA occlusion and for whom postinterventional 3T TOF-MRA (median at day 3) was available, were included in this retrospective analysis (n=98). LSA appearance was categorized into presence (LSA-sign + ) or absence (LSA-sign − ) of vasodilatation in the ischemic hemisphere. Functional outcome was determined using the modified Rankin scale (mRS). LSA-sign +  was observed in 64/98 patients. Hypertension (adjusted OR: 0.171, 95% CI: 0.046–0.645) and preinterventional IV rtPA (adjusted OR: 0.265, 95% CI: 0.088–0.798) were associated with absence of the LSA-sign + . In multivariate logistic regression, LSA-sign +  was associated with substantial neurologic improvement (adjusted OR: 10.18, 95% CI: 2.69–38.57) and good functional outcome (discharge-mRS ≤ 2, adjusted OR: 7.127, 95% CI: 1.913–26.551 and day 90 mRS ≤ 2, adjusted OR: 3.786, 95% CI: 1.026–13.973) after correcting for relevant confounders. For all clinical endpoints, model fit improved when including the LSA-sign term (p&lt;0.05). Asymmetrical dilatation of LSAs following successful thrombectomy indicates favorable neurologic and mid-term functional outcomes. This may indicate preserved cerebral blood flow regulatory mechanisms.

journal of cerebral blood flow and metabolism

Clinical outcome prediction after thrombectomy of proximal middle cerebral artery occlusions by the appearance of lenticulostriate arteries on magnetic resonance angiography: A retrospective analysis