Transcranial Doppler After Successful Endovascular Revascularization and Hospitalization Outcomes

Area of Science:

• Neurology
• Vascular Neurology
• Medical Imaging

Background:

• Large-vessel occlusion (LVO) strokes often have poor outcomes despite successful endovascular therapy.
• Post-treatment cerebral hemodynamics require further investigation for prognostic value.

Purpose of the Study:

• To determine if postrevascularization cerebral hemodynamics, assessed by transcranial Doppler (TCD), correlate with hospitalization outcomes in LVO stroke patients.

Main Methods:

• An observational cohort study of 155 patients with successfully revascularized anterior circulation LVO stroke.
• Transcranial Doppler (TCD) was performed within 48 hours of endovascular therapy.
• Blood flow signals were categorized using Thrombolysis in Brain Ischemia (TIBI) grades; logistic regression analyzed associations with modified Rankin Scale score, discharge destination, and mortality.

Main Results:

• Abnormal TCD blood flow (TIBI grade ≤4) was detected in 35% of patients.
• Low TIBI grades (≤3, dampened flow) were significantly associated with unfavorable modified Rankin Scale scores (aOR, 0.09) and discharge destinations (aOR, 0.22).
• Increased pulsatility index correlated with less favorable discharge destinations (aOR, 0.34), while mean and peak systolic velocities showed no association.

Conclusions:

• Transcranial Doppler (TCD) effectively identifies abnormal cerebral hemodynamics in a significant portion of LVO stroke patients post-successful endovascular therapy.
• Dampened flow (low TIBI grades) and elevated pulsatility index are associated with adverse hospitalization outcomes.
• TCD offers valuable prognostic information and may guide future therapeutic strategies for LVO stroke patients.