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High-resolution vessel wall imaging after mechanical thrombectomy.

Sami Al Kasab1, Girish Bathla2, Alberto Varon3

  • 1Department of Neurology, Medical University of South Carolina,USA.

The Neuroradiology Journal
|May 20, 2021
PubMed
Summary
This summary is machine-generated.

High-resolution MRI reveals significant arterial wall enhancement after mechanical thrombectomy for acute ischemic stroke. Stentrievers showed greater enhancement compared to aspiration catheters, indicating potential differences in vessel wall response.

Keywords:
Mechanical thrombectomycontact aspirationendothelial damagesignal intensitystroke

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Area of Science:

  • Neuroimaging
  • Vascular Neurology
  • Interventional Neuroradiology

Background:

  • Mechanical thrombectomy is a key treatment for acute ischemic stroke due to large vessel occlusion.
  • High-resolution magnetic resonance imaging (HR-MRI) offers detailed visualization of intracranial arteries.
  • Assessing arterial wall changes post-thrombectomy is crucial for understanding treatment effects.

Purpose of the Study:

  • To evaluate HR-MRI features of large intracranial arteries after mechanical thrombectomy.
  • To objectively quantify arterial wall enhancement following endovascular procedures.
  • To compare imaging findings between different thrombectomy device groups.

Main Methods:

  • Prospective recruitment of acute ischemic stroke patients undergoing mechanical thrombectomy.
  • Performance of HR-MRI within 24 hours, including T1 pre/post-contrast black-blood, 3D T2, CE-MRA, and SWI sequences.
  • Objective assessment of arterial wall enhancement using contrast ratio normalized to the pituitary stalk.

Main Results:

  • Significantly higher arterial wall enhancement in target vessels compared to reference vessels (P < 0.01).
  • Stentriever group showed an 82% increase in contrast ratio; contact aspiration group showed a 64% increase.
  • No significant correlation found between SWI volume and contrast ratio increase.

Conclusions:

  • HR-MRI enables objective quantification of arterial wall changes post-thrombectomy.
  • Preliminary findings suggest stentrievers are associated with greater arterial wall enhancement than reperfusion catheters.
  • Further research is warranted to elucidate the clinical significance of these imaging findings.