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The Location of Pretreatment Hyperdense Middle Cerebral Artery Sign Predicts the Outcome of Intraarterial Thrombectomy for Acute Stroke
Author(s) -
Man Shumei,
Hussain Muhammad Shazam,
Wisco Dolora,
Katzan Irene L.,
Aoki Junya,
Tateishi Yohei,
ChengChing Esteban,
Hui Ferdinand K.,
Masaryk Thomas J.,
Rasmussen Peter A.,
Uchino Ken
Publication year - 2014
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12115
Subject(s) - medicine , middle cerebral artery , stroke (engine) , occlusion , modified rankin scale , cardiology , ischemic stroke , ischemia , mechanical engineering , engineering
BACKGROUND AND PURPOSE Intraarterial (IA) mechanical thrombectomy has an excellent recanalization rate but does not always correlate with good clinical outcomes. We aimed to investigate whether hyperdense middle cerebral artery sign (HMCAS) on preintervention nonenhanced CT (NECT) predicts IA therapy outcome for acute stroke. METHODS Data were abstracted from our Hyperacute Ischemic Stroke database. Patients with occlusion in ICA, MCA, or MCA M2 branches who underwent IA therapy were included. RESULTS Among 126 patients who underwent IA treatment, 64 (51%) had hyperdense M1 MCA sign (M1 HMCAS), 11 (9%) had hyperdense M2, and 51 (40%) had No HMCAS (NHMCAS).M1 HMCAS and NHMCAS group has comparable baseline stroke severity and infarct volume ( P > .05); and the differences of favorable outcome (modified Rankin Score 0‐2) at 30 days were not significant (21% vs. 30%, P = .259). For those with HMCAS, favorable 30‐day outcome was most frequent in Distal HMCAS (39%), followed by hyperdense M2 (27%), HMCAS proximal (11%), and HMCAS full length (0%). CONCLUSIONS For acute ischemic stroke due to large vessel occlusion, the lack of HMCAS on NECT does not predict favorable outcome after IA therapy. Among those with HMCAS, proximal and longer HMCAS predicts unfavorable outcome.